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Association between cigarette smoking and prognosis in locally advanced cervical carcinoma treated with chemoradiation: a Gynecologic Oncology Group study.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2006 Dec; Vol. 103 (3), pp. 853-8. Date of Electronic Publication: 2006 Jul 03. - Publication Year :
- 2006
-
Abstract
- Objective: To determine if smoking, a known risk factor for a number of cancers including cervical cancer, is associated with poor prognosis in patients with locally advanced cervical carcinoma treated with chemoradiation.<br />Methods: Patients with primary, previously untreated, histologically confirmed stage II-B, III-B or IV-A cervical carcinoma participated in a Gynecologic Oncology Group (GOG) phase III study (GOG 165) and were randomly allocated to receive radiation plus either cisplatin or 5-fluorouracil. Smoking behavior was ascertained using an administered questionnaire and by quantifying urine cotinine concentration. Disease progression was defined as a >or=50% increase in the cross product of the existing tumor compared with previous assessments. Patients were followed until death.<br />Results: Of 328 enrolled patients, 12 were ineligible, one was inevaluable for reported smoking status and 40 others were inevaluable for cotinine-derived smoking status. Among evaluable patients, 133 (42%) were reported smokers and 111 (40%) were cotinine-derived smokers. The kappa for agreement between the groups was 0.872 (P<0.01). Compared with non-smokers, median survival was 15 months shorter for reported smokers and 20 months shorter for cotinine-derived smokers (P<0.01). After adjusting for covariates, a significant increase in the risk of death (but not disease progression) was observed for reported smokers (hazard ratio [HR]: 1.51; 95% confidence interval [CI]: 1.01-2.27; P=0.04) and cotinine-derived smokers (HR: 1.57; 95% CI: 1.03-2.38; P=0.04).<br />Conclusions: Smoking predicts worse overall survival in women with locally advanced cervical carcinoma treated with chemoradiation.
- Subjects :
- Adenocarcinoma epidemiology
Adenocarcinoma etiology
Adenocarcinoma mortality
Adenocarcinoma pathology
Adenocarcinoma therapy
Carcinoma, Adenosquamous epidemiology
Carcinoma, Adenosquamous etiology
Carcinoma, Adenosquamous mortality
Carcinoma, Adenosquamous pathology
Carcinoma, Adenosquamous therapy
Carcinoma, Squamous Cell epidemiology
Carcinoma, Squamous Cell etiology
Carcinoma, Squamous Cell mortality
Carcinoma, Squamous Cell pathology
Carcinoma, Squamous Cell therapy
Clinical Trials, Phase III as Topic
Combined Modality Therapy
Cotinine urine
Disease-Free Survival
Female
Humans
Neoplasm Metastasis
Neoplasm Staging
Prevalence
Prognosis
Risk Factors
Surveys and Questionnaires
Survival Analysis
United States epidemiology
Uterine Cervical Neoplasms etiology
Uterine Cervical Neoplasms mortality
Uterine Cervical Neoplasms pathology
Smoking adverse effects
Uterine Cervical Neoplasms epidemiology
Uterine Cervical Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0090-8258
- Volume :
- 103
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 16815535
- Full Text :
- https://doi.org/10.1016/j.ygyno.2006.05.017