Sex and Survival After Surgery for Lung Cancer: A Swedish Nationwide Cohort.
Sex and Survival After Surgery for Lung Cancer: A Swedish Nationwide Cohort.
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DOI：
10.1016/j.chest.2020.11.010
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发表时间：
2021-05
期刊：
影响因子：
9.6
通讯作者：
Jackson V
中科院分区：
文献类型：
--
作者：
Sachs E;Sartipy U;Jackson V
先前关于肺癌患者手术和非手术队列中女性生存率可能更高的报道是相互矛盾的。以前报道的肺癌手术后生存率的差异可能是由于对男性和女性风险因素特征差异控制不足的结果。当考虑到广泛的预后因素时，接受肺切除术治疗肺癌的女性预后是否优于男性？我们进行了一项全国性的基于人群的观察性队列研究，分析了肺癌肺切除术后的性别特异性生存率。我们从瑞典普通胸外科国家质量登记册中确定了6356例患者，并将个人记录与其他国家健康数据登记册进行了链接，以获取有关合并症、社会经济状况和生命状态的详细信息。使用治疗加权的逆概率来解释基线特征的差异。使用考克斯回归模型评估女性性别与全因死亡率之间的相关性，并使用灵活的参数生存模型估计绝对生存差异及其95% CI。我们还估计了限制平均生存时间的差异。我们观察到女性的死亡风险低于男性（风险比，0.73; 95%CI，0.67-0.79）。1年、5年和10年的绝对生存率差异分别为3.0%（95% CI，2.2%-3.8%）、10%（95% CI，7.0%-12%）和12%（95% CI，8.5%-15%）。10年时的限制性平均生存时间差为0.84年（95%CI，0.61-1.07年）。这些发现在几个亚组中是一致的。接受肺切除术治疗肺癌的女性预后明显好于男性。无论年龄、常见合并症、社会经济状况、生活方式因素、身体状况、手术类型和程度、肿瘤特征和疾病分期如何，生存优势都是明显的。ClinicalTrials.gov;编号：NCT03567538; URL：www.clinicaltrials.gov
Prior reports on a possible female survival advantage in both surgical and nonsurgical cohorts of patients with lung cancer are conflicting. Previously reported differences in survival after lung cancer surgery could be the result of insufficient control for disparities in risk factor profiles in men and women. Do women who undergo pulmonary resections for lung cancer have a better prognosis than men when taking a wide range of prognostic factors into account? We performed a nationwide population-based observational cohort study analyzing sex-specific survival after pulmonary resections for lung cancer. We identified 6356 patients from the Swedish National Quality Register for General Thoracic Surgery and performed individual-level record linkage to other national health-data registers to acquire detailed information regarding comorbidity, socioeconomic status, and vital status. Inverse probability of treatment weighting was used to account for differences in baseline characteristics. The association between female sex and all-cause mortality was assessed with Cox regression models, and flexible parametric survival models were used to estimate the absolute survival differences with 95% CIs. We also estimated the difference in restricted mean survival time. We observed a lower risk of death in women compared with men (hazard ratio, 0.73; 95% CI, 0.67-0.79). The absolute survival difference at 1, 5, and 10 years was 3.0% (95% CI, 2.2%-3.8%), 10% (95% CI, 7.0%-12%), and 12% (95% CI, 8.5%-15%), respectively. The restricted mean survival time difference at 10 years was 0.84 year (95% CI, 0.61-1.07 years). The findings were consistent across several subgroups. Women who underwent pulmonary resections for lung cancer had a significantly better prognosis than men. The survival advantage was evident regardless of age, common comorbidities, socioeconomic status, lifestyle factors, physical performance, type and extent of surgery, tumor characteristics, and stage of disease. ClinicalTrials.gov; No.: NCT03567538; URL: www.clinicaltrials.gov
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DOI：
10.1016/s0140-6736(18)32203-7
发表时间：
2018-11-10
期刊：
Lancet (London, England)
影响因子：
--
作者：
GBD 2017 Causes of Death Collaborators
通讯作者：
GBD 2017 Causes of Death Collaborators
影响因子：
--
作者：
Huang WY;Li CH;Lin CL;Liang JA
通讯作者：
Liang JA
影响因子：
3.1
作者：
Dalton, Susanne O.;Steding-Jesen, Marianne;Johansen, Christoffer
通讯作者：
Johansen, Christoffer
影响因子：
51.1
作者：
Bendixen, Morten;Jorgensen, Ole Dan;Licht, Peter Bjorn
通讯作者：
Licht, Peter Bjorn
影响因子：
1.7
作者：
Fritz, Ildiko;Olsson, Hakan
通讯作者：
Olsson, Hakan