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Ann Thorac Surg 2005;80:1033-1039
© 2005 The Society of Thoracic Surgeons

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Original article: General thoracic

Alcohol Abuse Predicts Progression of Disease and Death in Patients with Lung Cancer

^a Department of Surgery, Department of Veterans Affairs Medical Center, Dayton, Ohio
^b Department of Hematology and Oncology, Department of Veterans Affairs Medical Center, Dayton, Ohio
^c Department of Radiation Oncology, Department of Veterans Affairs Medical Center, Dayton, Ohio
^d Department of Surgery, Wright State University School of Medicine, Dayton, Ohio
^e Department of Hematology and Oncology, Wright State University School of Medicine, Dayton, Ohio

Accepted for publication March 18, 2005.

^_* Address reprint requests to Dr Paull, Wright State University School of Medicine, Department of Surgery, No. 112, VA Medical Center, 4100 W Third St, Dayton, OH45428 (Email: douglas.paull{at}wright.edu).

BACKGROUND: Few studies have examined long-term outcomes in alcohol-abusing patients with lung cancer. The purpose of this study was to examine the effect of alcohol abuse on the prognosis of patients with lung cancer.

METHODS: The study was composed of 114 consecutive patients with nonsmall-cell lung cancer treated at a Department of Veterans Affairs Medical Center. An alcohol-abusing group consisted of 36 patients with one of the following at the time of lung cancer diagnosis: positive screening questionnaire, alcohol consumption more than 5 drinks or cans of beer a day, or criteria for a diagnosis of alcohol dependence/abuse according to the Diagnostic and Statistical Manual for Mental Disorders IV. The comparison group consisted of 78 nonabusing patients.

RESULTS: Alcohol abusers, compared with nonabusers, had worse Kaplan-Meier overall survival (median 8.5 versus 17.5 months, p = 0.05) and progression-free survival (median 6.0 versus 15.5 months, p = 0.04). In multivariate analyses including alcohol abuse, Charlson comorbidity, pack-years smoking, performance status, and stage, only stage of disease, performance status, and alcohol abuse (odds ratio = 3.44, 95% confidence interval = 1.17 to 10.1, p = 0.02) predicted progression of disease or death within 12 months of diagnosis. Alcohol abuse was also an independent predictor of disease-specific survival (hazard ratio = 1.65, 95% confidence interval = 1.01 to 2.80, p = 0.05) and progression-free survival (hazard ratio = 1.79, 95% confidence interval = 1.12 to 2.86, p = 0.01) among patients with lung cancer.

CONCLUSIONS: Alcohol-abusing patients with nonsmall-cell lung cancer have worse outcomes than nonabusing patients. The adverse prognosis associated with alcohol abuse is independent of comorbidity, performance status, or smoking history.

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