Oncology · Surgery · 2 h ago
Current Smoking Linked to Lower TNT Response in Rectal Cancer Cohort
In a retrospective National Cancer Database cohort of 1,767 adults with stage II–III rectal cancer treated with total neoadjuvant therapy (TNT) and proctectomy, current smokers had lower rates of favorable neoadjuvant rectal (NAR) scores and pathologic complete response than never smokers. The adjusted association was statistically significant for favorable NAR score, but not for pathologic complete response.
- Current smokers had lower rates of favorable NAR scores.
- The adjusted NAR association was statistically significant.
- The pCR association did not reach statistical significance.
- Retrospective findings do not show cessation improves response.
Researchers conducted a retrospective cohort study using National Cancer Database records for adults diagnosed in 2023 with clinical stage II–III rectal adenocarcinoma who received TNT followed by proctectomy. The analysis included 1,767 patients: 49.7% were never smokers, 30.5% former smokers, and 19.8% current smokers. Outcomes were a favorable NAR score (<8) and pathologic complete response (ypT0N0).
Favorable NAR scores occurred in 33.4% of never smokers, 28.8% of former smokers, and 25.5% of current smokers. Corresponding pCR rates were 21.7%, 19.9%, and 16.3%. After multivariable adjustment, current smoking was associated with lower odds of a favorable NAR score than never smoking (odds ratio 0.59; 95% CI 0.40–0.86). The association with pCR was similar in direction but did not reach statistical significance (odds ratio 0.58; 95% CI 0.34–1.00). Former smoking was not significantly associated with either outcome compared with never smoking.
The findings link current smoking with less favorable pathologic response after TNT, but the retrospective design cannot establish causation or show that smoking cessation improves response. The study assessed outcomes among patients who proceeded to proctectomy, and its results do not establish a change in treatment strategy.
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Annals of Surgical Oncology: Smoking Status and Response to Total Neoadjuvant Therapy for Rectal Cancer: A National Cohort Study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.