EGFR mutation, smoking, and gender in advanced lung adenocarcinoma

Chien Hua Tseng, Chun Ju Chiang, Jeng Sen Tseng, Tsung Ying Yang, Kuo Hsuan Hsu, Kun Chieh Chen, Chih Liang Wang, Chih Yi Chen, Sang Hue Yen, Chun Ming Tsai, Ming Shyan Huang, Chao Chi Ho, Chong Jen Yu, Ying Huang Tsai, Jin Shing Chen, Teh Ying Chou, Ming Hsun Tsai, Hsuan Yu Chen, Kang Yi Su, Jeremy J.W. ChenHuei Wen Chen, Sung Liang Yu, Tsang Wu Liu, Gee Chen Chang

Research output: Contribution to journalArticlepeer-review

53 Citations (Scopus)


Purpose: In the current targeted therapy era, information on the effect of smoking in epidermal growth factor receptor (EGFR)-mutant lung cancer patients is scarce. Results: In total, 11,678 adenocarcinoma patients were enrolled. Of these, 33.3% and 91.8% of male and female patients were non-smokers, respectively. An increased amount of smoking (P < 0.001 for trend), fewer smoke-free years (P < 0.001 for trend), and younger age of smoking initiation (P = 0.034 for trend) were all associated with significantly lower EGFR mutation rates. Smokers had a shorter median overall survival (OS) among both EGFR-mutant and EGFR-wild type patients (17.8 vs. 21.1 months, and 7.9 vs. 11.4 months respectively; both P < 0.001). Among patients with EGFR-mutant adenocarcinoma, younger smokers were associated with shorter OS (P = 0.047). In multivariate analysis, female gender was an independent prognostic factor for OS (hazard ratio: 0.86 [95% confidence interval (CI): 0.80-0.93]; P < 0.001 in the EGFRmutant group and 0.88 [95% CI: 0.81-0.96]; P = 0.004 in the EGFR-wild type group). Materials and Methods: We reviewed the National Lung Cancer database (Taiwan) to assess the impact of smoking on the EGFR mutation rate and survival in advanced lung adenocarcinoma patients during 2011 and 2014 retrospectively. Conclusions: Smoking was associated with lower incidence of EGFR mutation rate and reduced OS of advanced lung adenocarcinoma patients in a dose-dependent manner. In addition to EGFR mutation and smoking, gender also plays an important role in survival among these patients.

Original languageEnglish
Pages (from-to)98384-98393
Number of pages10
Issue number58
Publication statusPublished - Jan 1 2017


  • Epidermal growth factor receptor (EGFR) mutation
  • Lung adenocarcinoma
  • Overall survival
  • Smoking

ASJC Scopus subject areas

  • Oncology


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