Systematic review and meta-analysis of studies of associations of smoking and complications after cancer surgery

Surgical cancer treatments may be delayed for patients who smoke over concerns for increased risk of complications. Quantifying risks for people who had recently smoked can inform any trade-offs of delaying surgery. A meta-analysis of 24 studies (pooled sample of 39,499 participants) published between January 1, 2000, to August 10, 2023, found that patients who hade smoked within 4 weeks of cancer surgery had 31% greater odds of postoperative complication versus those who had quit for longer and 183% greater odds of postoperative complications versus those who had never smoked. There was no statistically significant difference between patients who had smoked within 2 weeks of surgery and those who last smoked 2 week to 3 monts prior. The authors conclude that these results suggest that earlier intervention and smoking cessation therapies may reduce the risk of postoperative complications among patients undergoing cancer surgery.