Sex differences in survival in non-small cell lung cancer patients 1974-1998
Sex differences in survival in non-small cell lung cancer patients 1974-1998
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DOI：
10.1080//02841860310017973
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发表时间：
2004-01-01
期刊：
影响因子：
3.1
通讯作者：
Khuri, F
中科院分区：
文献类型：
--
作者：
Moore, R;Doherty, D;Khuri, F
这项研究包括1974年至1998年期间在综合癌症中心接受治疗的7553名非小细胞肺癌患者(2660名女性和4893名男性)。肿瘤组织学上的显著差异与性别有关(p<；0.001)；腺癌是男性(50.0%)和女性(41.7%)中最常见的诊断；鳞状细胞癌是第二常见的诊断(女性和男性分别为21%和31%)；细支气管肺泡癌在男性中更为常见(3%对女性为7%)。在登记时患有本地、地区或远程疾病的频率分布在男性和女性之间相似(p=0.906)。在多变量COX回归分析中，表明性别是影响生存的重要危险因素。调整了年龄、分期、接受的治疗和支付医疗费用的能力后，发现性别和肿瘤组织学之间存在统计学上显著的交互作用(p=0.043)，其中，相对于女性和鳞癌以外的组织学，患有鳞癌的女性死亡风险增加(HR=1.09，95%CI 1.02-1.18)，而男性在所有组织学中的死亡风险增加(HR=1.29，95%CI 1.21-1.40；HR=1.15，95%CI 1.07-1.24对于鳞癌和其他组织学，分别)。这项研究证实了之前的报道，即非小细胞肺癌患者的生存率存在明显的性别差异，包括女性患者的组织学特异性影响。
This study comprised a total of 7 553 patients with non-small cell lung cancer (2 660 women and 4 893 men) treated at a comprehensive cancer centre between 1974 and 1998. Significant differences in tumour histology were associated with gender (p < 0.001); adenocarcinoma was the most common diagnosis in both men (50.0%) and women (41.7%); squamous cell carcinoma was the second most prevalent diagnosis (21% and 31% in women and men, respectively); and bronchioalveolar tumours were more prevalent in men (3% compared with 7% in women). Frequency distributions with local, regional or distant disease at registration were similar between men and women (p = 0.906). In a multivariable Cox regression analysis the indications were that gender is an important risk factor for survival. Adjusting for age, stage, treatment received and ability to pay for care, a statistically significant interaction between gender and tumour histology (p = 0.043) was found, where, in relation to female sex and histologies other than squamous carcinoma, women who presented with squamous carcinoma had an increased risk of death (HR = 1.09, 95% CI 1.02-1.18) while men had an increased risk of death for all histologies (HR = 1.29, 95% CI 1.21-1.40, and HR = 1.15, 95% CI 1.07-1.24 for squamous and other histologies, respectively). This study confirms previous reports of strong gender-dependent differences in survival in patients with non-small cell lung cancer, including a histology-specific effect in women.