Do women live longer following lung resection for carcinoma?

Abstract

This study suggests that female gender exerts a significant positive effect on survival following lung resection for NSCLC. This effect is pronounced at early disease stage and persists after adjusting for important differences in the clinical, histo-pathological features and extent of pulmonary resection between male and female patients.

Female Gender Is an Independent Prognostic Factor in Non-small-cell Lung Cancer: A Meta-analysis

“…Biologic features of adenocarcinomas in women, as represented by localized bronchioloalveolar carcinomas (BACs) showing low aggressiveness, may result in better prognoses. 12) Multiple previous studies [13][14][15] reported a survival advantage for women with resected NSCLC to be limited to patients with earlier disease stages or a nonsquamous histology. If this is so, the proportion of stage I and adenocarcinoma cases, and probably smoking status in the patients studied might affect comparisons of survival between genders.…”

“…Overlapping or unrelated articles were excluded, and items from hand-searched bibliographies were added. Of the 65 articles initially found by these methods, 26 [13][14][15] were excluded for reasons described in Table 1. Among the excluded studies, 18 showed results of univariate analyses, and the other 8 studies used multivariate analyses.…”

Unreported Financial Disclosures

“…[18][19][20] Cancer stage at diagnosis, cell type, or treatment do not appear to be entirely explanatory of this difference. 21 As 85% (229/269) of the cases considered here were clinical stage I at diagnosis, the fatality hazard ratio in favor of women, conditional for pack-years of smoking, disease stage, tumor cell type, and resection was more pronounced than those reported by others.…”

“…Women have been reported to have higher survival rates regardless of the stage of the disease at diagnosis, 9,[12][13][14][15][16][17][18][19][20][21] the most recent evidence in the United States derived from the national Surveillance, Epidemiology, and End Results (SEER) database 9 and a large cohort at the Mayo Clinic. 21 Since our previous report, screening has continued at the original ELCAP institutions and has markedly expanded the amount of poolable data by institutions collaborating worldwide in the International Early Lung Cancer Action Project (I-ELCAP).…”

“…It is well-established by the evidence accumulated over the past 20 years that women with lung cancer survive the disease better than men, 9,[12][13][14][15][16][17][18][19][20] and that this difference is more pronounced when the cancer is diagnosed at an early stage. [18][19][20] Cancer stage at diagnosis, cell type, or treatment do not appear to be entirely explanatory of this difference.…”