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Objective <p>This study aimed to elucidate the relationship between smoking extent and prognosis, imaging characteristics, and clinicopathological factors in patients with clinical stage I lung adenocarcinoma (c-stage I LDA).</p> Methods <p>We evaluated 2,285 patients who underwent surgical resection for c-stage I LDA between 2010 and 2018. Patients were classified into three groups based on the Brinkman Index (BI): never smokers (BI = 0), light smokers (0 &lt; BI ≤ 600), and heavy smokers (BI &gt; 600). Clinicopathological features and prognosis were analyzed according to smoking extent.</p> Results <p>Significant differences in overall survival (OS) were observed across the smoking groups. Heavy smokers exhibited more invasive imaging characteristics, including a larger solid proportion and a higher maximum standardized uptake value (SUVmax), compared to never and light smokers. In multivariable analyses, heavy smoking was significantly associated with poorer OS (hazard ratio [HR] 2.071, <i>p</i> &lt; 0.001). In addition, older age (HR 1.111, <i>p</i> &lt; 0 .001) and the presence of vascular invasion (HR 2.312, <i>p</i> &lt; 0.001) were also associated with worse OS among heavy smokers.</p> Conclusion <p>Smoking extent was independently associated with poorer survival, larger solid tumor size, and higher SUVmax in patients with c-stage I LDA. Age and vascular invasion emerged as strong prognostic factors, particularly among heavy smokers.</p>

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Prognosis, imaging characteristics, and clinicopathological features of heavy smokers with clinical stage I lung adenocarcinoma: a multicenter study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月10日

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  • Ikki Takada,
  • Yoshihisa Shimada,
  • Takahiro Mimae,
  • Yujin Kudo,
  • Takuya Nagashima,
  • Yoshihiro Miyata,
  • Hiroyuki Ito,
  • Morihito Okada,
  • Norihiko Ikeda

摘要

Objective

This study aimed to elucidate the relationship between smoking extent and prognosis, imaging characteristics, and clinicopathological factors in patients with clinical stage I lung adenocarcinoma (c-stage I LDA).

Methods

We evaluated 2,285 patients who underwent surgical resection for c-stage I LDA between 2010 and 2018. Patients were classified into three groups based on the Brinkman Index (BI): never smokers (BI = 0), light smokers (0 < BI ≤ 600), and heavy smokers (BI > 600). Clinicopathological features and prognosis were analyzed according to smoking extent.

Results

Significant differences in overall survival (OS) were observed across the smoking groups. Heavy smokers exhibited more invasive imaging characteristics, including a larger solid proportion and a higher maximum standardized uptake value (SUVmax), compared to never and light smokers. In multivariable analyses, heavy smoking was significantly associated with poorer OS (hazard ratio [HR] 2.071, p < 0.001). In addition, older age (HR 1.111, p < 0 .001) and the presence of vascular invasion (HR 2.312, p < 0.001) were also associated with worse OS among heavy smokers.

Conclusion

Smoking extent was independently associated with poorer survival, larger solid tumor size, and higher SUVmax in patients with c-stage I LDA. Age and vascular invasion emerged as strong prognostic factors, particularly among heavy smokers.