Sex is a strong prognostic factor in stage IV non-small-cell lung cancer patients and should be considered in survival rate estimation

被引：19

作者：

Barquin, Miguel ^{[1
]}

Calvo, Virginia ^{[1
]}

Garcia-Garcia, Francisco ^{[2
]}

Nunez, Beatriz ^{[1
]}

Sanchez-Herrero, Estela ^{[1
]}

Serna-Blasco, Roberto ^{[1
]}

Auglyt, Milda ^{[1
]}

Carcereny, Enric ^{[3
]}

Rodriguez-Abreu, Delvys ^{[4
]}

Castro, Rafael Lopez ^{[5
]}

Guirado, Maria ^{[6
]}

Camps, Carlos ^{[7
]}

Bosch-Barrera, Joaquin ^{[8
]}

Massuti, Bartomeu ^{[9
]}

Ortega, Ana Laura ^{[10
]}

del Barco, Edel ^{[11
]}

Gonzalez-Larriba, Jose Luis ^{[12
]}

Aguiar, David ^{[13
]}

Garcia-Campelo, Rosario ^{[14
]}

Domine, Manuel ^{[15
]}

Agraso, Sara ^{[16
]}

Sala, Ma Angeles ^{[17
]}

Oramas, Juana ^{[18
]}

Bernabe, Reyes ^{[19
]}

Blanco, Remei ^{[20
]}

Parejo, Consuelo ^{[21
]}

Cruz, Alberto ^{[1
]}

Menasalvas, Ernestina ^{[22
]}

Royuela, Ana ^{[23
]}

Romero, Atocha ^{[1
]}

Provencio, Mariano ^{[1
]}

机构：

[1] Hosp Univ Puerta Hierro Majadahonda, Madrid, Spain

[2] Principe Felipe Res Ctr, Bioinformat & Biostat Unit, Valencia, Spain

[3] Hosp Badalona Germans Trias & Pujol, Inst Catala Oncol Badalona, B ARGO Grp Badalona Appl Res Grp Oncol, Badalona, Spain

[4] Hosp Insular Gran Canaria, Las Palmas Gran Canaria, Spain

[5] Hosp Clin Univ Valladolid, Valladolid, Spain

[6] Hosp Gen Univ Elche, Elche, Spain

[7] Hosp Gen Univ Valencia, Valencia, Spain

[8] Catalan Inst Oncol, Girona, Spain

[9] Hosp Univ Gen Alicante, Alicante, Spain

[10] Complejo Hosp Jaen, Jaen, Spain

[11] Hosp Univ Salamanca, Salamanca, Spain

[12] Hosp Clin San Carlos, Madrid, Spain

[13] Hosp Univ Gran Canaria Dr Negrin, Las Palmas Gran Canaria, Spain

[14] Hosp Univ La Coruna, La Coruna, Spain

[15] Hosp Fdn Jimenez Diaz, Madrid, Spain

[16] Complejo Hosp Univ Vigo, Vigo, Spain

[17] Hosp Basurto, Bilbao, Spain

[18] Hosp Univ Canarias, Tenerife, Spain

[19] Hosp Univ Virgen Rocio, Seville, Spain

[20] Hosp Terrassa, Barcelona, Spain

[21] Hosp Univ Puerta Hierro Majadahonda, TIC Unit, Med Oncol Dept, Madrid, Spain

[22] Univ Politecn Madrid, Ctr Biomed Technol, Madrid 28000, Spain

[23] Hosp Univ Puerta Hierro Majadahonda, CIBERESP, Biostat Unit, Madrid, Spain

来源：

CANCER EPIDEMIOLOGY | 2020年 / 67卷

基金：

欧洲研究理事会;

关键词：

Non-small cell lung cancer; EGFR; Gender; Female; Sex; GENDER; SMOKING; WOMEN; MANAGEMENT; EXPRESSION; RESECTION; MEDICINE;

D O I：

10.1016/j.canep.2020.101737

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Biological differences between the sexes have a major impact on disease and treatment outcome. In this paper, we evaluate the prognostic value of sex in stage IV non-small-cell lung cancer (NSCLC) in the context of routine clinical data, and compare this information with other external datasets. Methods: Clinical data from stage IV NSCLC patients from Hospital Puerta de Hierro (HPH) were retrieved from electronic health records using big data analytics (N = 397). In addition, data from the Spanish Lung Cancer Group (GECP) Tumor Registry (N = 1382) and from a published study available from the cBioPortal (MSK) (N = 601) were analyzed. Survival curves were estimated using the Kaplan-Meier method. A Cox proportional hazards regression model was used to assess the prognostic value of sex. A meta-analysis to compare the outcome for males and females in terms of overall survival (OS) and progression free survival (PFS) was performed. Results: The median OS time was 12 months for males and 19 months for females (overall HR = 0.77; 95% CI: 0.68-0.87; P < 0.001). Similarly, females with stage IV NSCLC harboring an EGFR-sensitizing mutation lived significantly longer than males (median OS: males, 19 months; females, 32 months) with a lower risk of death compared with males (overall HR = 0.75; 95% CI: 0.67-0.84). In addition, female patients benefited more from EGFR inhibitors in terms of PFS and OS (overall HR = 0.45; 95% CI: 0.32-0.64, and HR = 0.62; 95% CI: 0.48-0.80, respectively). Median PFS was 21 months in females and 12 months in males (P < 0.001). Conclusions: Using routine clinical data we confirmed the previous finding that among stage IV NSCLC patients, females had a significantly better prognosis than males. The effect size of the sex was notable, highlighting the fact that survival rates are usually estimated and patients are generally managed without considering the sexes separately, which may lead to suboptimal results.

引用

页数：7

共 30 条

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