Female patients with small cell lung cancer live longer than male patients

Johnson, Bruce E.; Steinberg, Seth M.; Phelps, Ruby; Edison, Margaret; Veach, Stephen R.; Ihde, Daniel C.

doi:10.1016/s0002-9343(88)80341-3

Cited by 81 publications

(32 citation statements)

References 10 publications

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“…In most North American series, prognosis is significantly more favourable among women (Davis et al, 1985;Johnson et al, 1988;Spiegelman et al, 1989;Wolf et al, 1991;Chute et al, 1997). Neither in our study nor in a French series of 1280 patients included in four consecutive trials did sex appear as a significant independent factor.…”

Section: Discussionmentioning

confidence: 99%

Progress in the management and outcome of small-cell lung cancer in a French region from 1981 to 1994

Lebitasy¹,

Hédelin

Purohit³

et al. 2001

Br J Cancer

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Summary Recent analyses of series of small-cell lung cancer (SCLC) patients included in clinical trials have shown improved survival over time, but it has been impossible to determine whether this was due to selection biases, stage migration, or true therapeutic improvement. To determine if there has been a true improvement of survival over time, we reviewed the medical records of all consecutive patients diagnosed with SCLC between 1981 and 1994 in the Bas-Rhin in France. Among the 787 patients (median age 63), there was no significant period effect for sex, age, or stage. Staging work-ups became increasingly thorough (significant period effect). The mean number of investigations and of tumour sites detected correlated significantly. The chemotherapy rate increased (from 76.4% in 1981-1983 to 91.7% in 1993-1994, P = 10 -5 ) and mediastinal irradiation decreased (to roughly 25% of patients after 1983). Median survival time increased for the overall population from 6.6 months in 1981-1983 to 11.3 months in 1993-1994 (P = 10 -5 ), for patients with limited disease (LD) from 9.2 (P = 0.002) months to 14.0 months, and for those with extensive (ED) disease from 3.5 months to 9.6 months (P = 10 -5 ). Significant independent prognostic factors were disease extent, clinical trial participation, period, type of chemotherapy, and mediastinal irradiation in LD. Survival time has truly improved as 'state of the art' management of SCLC has changed.

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Section: Discussionmentioning

confidence: 99%

Progress in the management and outcome of small-cell lung cancer in a French region from 1981 to 1994

Lebitasy¹,

Hédelin

Purohit³

et al. 2001

Br J Cancer

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“…As a result the trial population was reflected in the off study population that was analysed. Furthermore, the distribution of males and females between the two study groups was very similar, minimising the effect of the possible favourable prognostic factor of female gender (Johnson et al, 1988). Reports claiming a benefit for the control group treated within a trial have in the past compared different treatment regimens given on and off study, which, could account for any survival difference (Edwards et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

Identical chemotherapy schedules given on and off trial protocol in small cell lung cancer response and survival results

et al. 2002

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Patients who are treated within clinical trials may have a survival benefit dependent on being a trial participant. A number of factors may produce such beneficial outcome including more rigorous adherence to a peer reviewed trial protocol, management by an experienced treatment team, being treated in a specialist centre etc. The current investigation compared patients treated on and off trial with the same standard arm treatment regimen. The results could then be interpreted without the confounding factors of differing treatment regimens, treatment teams or treatment hospitals. The results demonstrated given these circumstances that survival was no different for patients participating in a randomised trial compared with a group of patients similarly treated who were not eligible for trial entry or who declined randomisation. These results were obtained by the rigorous adherence to a defined protocol with the invaluable assistance of designated lung cancer staff.

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“…In the literature, these results have not been consistent. In 1988, Johnson et al reported an improved 2.5-year survival in females with SCLC compared to males in North America [5]. Trials in Cancer and Leukaemia Group B reported improved survival in females in cases of both LD as well as ED [27].…”

Section: Sclcmentioning

confidence: 99%

“…Patient gender, with a better prognosis seen in females, has been recognized as a significant factor in SCLC [5] since the 1980s, and since the 1990s in NSCLC patients [6].…”

Section: Introductionmentioning

confidence: 99%

Gender-Related Survival in Different Stages of Lung Cancer—A Population Study over 20 Years

Svensson¹,

Ewers²,

Ohlsson³

et al. 2014

OJIM

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Introduction: Tumour stage is the most important prognostic factor in non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). The aim of this study was to evaluate if female gender was a prognostic factor in different tumour stages in relation to histology and given therapy. Methods: From 1989-2008, 1497 patients in eastern Scania, in southern Sweden with 202,000 inhabitants, were referred and prospectively registered. Tumour stage, performance status, lung cancer type and primary therapy were registered. Results: In NSCLC, female patients in stages 1 and 2 who were treated with surgery had a better 5-year survival rate (79.4%), compared to males (60.6%; p = 0.0004). Female patients in stage 3 with active therapy (surgery and/or radiotherapy and/or chemotherapy) had a better 5-year survival than males (20.6% vs. 10.5%, respectively, p = 0.0006). Female patients with adenocarcinoma were favourable in stages 1-3. In stage 4, there was no survival difference between females and males. In SCLC, females with limited disease (LD) and active therapy (chemotherapy ± radiotherapy ± surgery) had a higher 5-year survival rate (28%) than males (5.6%); p = 0.001. Females with extensive disease (ED) and active therapy (chemotherapy ± radiotherapy) had a better 5-year survival (3.9%) compared to males (0.7%); p = 0.023. In multivariate analyses, patient performance status at diagnosis was also an independent prognostic factor in all tumour stages of lung cancer. Conclusions: This population-based study corroborates a female survival advantage in NSCLC stages 1-3, but not in metastatic stage 4, and this is also demonstrated for the adenocarcinoma subgroup. The study also confirms better prognosis in females with SCLC in both LD and ED. The study also demonstrates the importance of patient performance status as a prognostic factor in all stages of lung cancer.

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Female patients with small cell lung cancer live longer than male patients

Cited by 81 publications

References 10 publications

Progress in the management and outcome of small-cell lung cancer in a French region from 1981 to 1994

Progress in the management and outcome of small-cell lung cancer in a French region from 1981 to 1994

Identical chemotherapy schedules given on and off trial protocol in small cell lung cancer response and survival results

Gender-Related Survival in Different Stages of Lung Cancer—A Population Study over 20 Years

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