The effect of ambient PM(2.5) exposure on survival of lung cancer patients after lobectomy

环境PM2.5暴露对肺癌患者肺叶切除术后生存率的影响

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Abstract

Exposure to fine particulate matter (PM(2.5)) is linked to lung cancer incidence and mortality. However, the impact of PM(2.5) exposure on lung cancer patients after lobectomy, which remains the primary treatment for early-stage lung cancer, is unknown. Therefore, we investigated the correlation between PM(2.5) exposure and the survival of lung cancer patients after lobectomy. This study included 3,327 patients with lung cancer who underwent lobectomy procedures. We converted residential addresses into coordinates and estimated individual patients' daily PM(2.5) and O(3) exposure levels. A Cox multivariate regression model was used to analyze the specific monthly association between PM(2.5) exposure and lung cancer survival. Every 10 μg/m(3) increase in monthly PM(2.5) concentration in the first and second months after lobectomy increased the risk of death (hazard ratio [HR]: 1.043, 95% confidence interval [CI]: 1.019-1.067 and HR: 1.036, 95% CI: 1.013-1.060, respectively). Non-smokers, younger patients, and patients with longer hospitalization durations had worse survival rates when exposed to greater concentrations of PM(2.5). High postoperative PM(2.5) exposure immediately after lobectomy reduced the survival of patients with lung cancer. Patients living in areas with high PM(2.5) should be offered the opportunity to transfer to areas with better air quality after undergoing lobectomies, to prolong their survival times.

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