Improved Survival in Never-Smokers vs Current Smokers With Primary Adenocarcinoma of the Lung

Nordquist, Luke T.; Simon, George R.; Cantor, Alan; Alberts, W. Michael; Bepler, Gerold

doi:10.1378/chest.126.2.347

Cited by 205 publications

(177 citation statements)

References 12 publications

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“…Percentages of adenocarcinoma in individual studies ranged from 17.3% to 100%. 51,66,67) Disease stages included varied from study to study; some studies analyzed only stage IA disease undergoing complete resection, 46,53,62,65) while some others included only unresectable stage IIIB and IV patients scheduled for chemotherapy or chemoradiotherapy. 56,59,75) Final statistical analyses used either univariate or multivariate analyses, or both.…”

Section: Resultsmentioning

confidence: 99%

“…Hsu et al 78) reported that median survival was the same for never-smoking women and never-smoking men with adenocarcinoma, suggesting that both smoking status and histologic type rather than gender decided survival. In several studies, 34,40,70) a significant survival advantage for women disappeared after statistically adjusting for smoking status, although in other studies 28,41,49,51,53,57,58,76,77) survival advantages for women persisted after adjustment for smoking. In our meta-analysis, which combined these conflicting studies, female gender still persisted as a favorable prognostic factor, independent of smoking status.…”

Section: Figmentioning

confidence: 94%

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

Nakamura

Ando

Shinmyo

et al. 2011

Ann Thorac Cardiovasc Surg

118

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Purpose: It is not clear whether women with non-small-cell lung cancer (NSCLC) live significantly longer than men. Thus, we conducted a meta-analysis of published studies to quantitatively compare NSCLC survival data between genders. Materials and Methods: A MEDLINE Web search for computer-archived bibliographic data regarding overall survival differences between genders was performed. DerSimonian-Laird random effects analysis was used to estimate the pooled hazard ratio (HR). Results: We selected 39 articles as appropriate data sources, involving 86 800 patients including 32 701 women and 54 099 men. Combined HRs for women vs. men in studies using univariate and multivariate analyses respectively were 0.79 (p <0.0001) and 0.78 (p <0.0001). Pooled HRs for 3 study subgroups having (1) fewer than 30% stage I cases, (2) fewer than 50% adenocarcinoma cases, and (3) statistical adjustment for smoking status all indicated the survival advantage of women. Conclusion: This meta-analysis of published data concerning NSCLC patients indicated significantly better survival for women.

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Section: Resultsmentioning

confidence: 99%

Section: Figmentioning

confidence: 94%

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

Nakamura

Ando

Shinmyo

et al. 2011

Ann Thorac Cardiovasc Surg

118

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“…Tobacco smoking has been shown to be at least a modest predictor of poor survival in patients with NSCLC 14,[19][20][21][22] ; however, SEER data do not contain information on smoking status. Similar to other population-based analyses, there was no centralized repeat review of pathologic specimens, which results in heterogeneity of reporting practices.…”

Section: Discussionmentioning

confidence: 99%

Survival improvements for advanced stage nonbronchioloalveolar carcinoma‐type nonsmall cell lung cancer cases with ipsilateral intrapulmonary nodules

Zell¹,

Ou²,

Ziogas³

et al. 2007

Cancer

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BACKGROUND. Survival improvements have been demonstrated for patients with bronchioloalveolar (BAC) nonsmall cell lung cancer (NSCLC) with intrapulmonary satellite T4 nodules compared with other patients with stage IIIB disease, and for ipsilateral intrapulmonary M1 tumors versus contralateral or distant metastasis. However, it is not known whether these differences are observed in patients with non‐BAC NSCLC. METHODS. A case‐only analysis of the U.S. Surveillance, Epidemiology, and End Results (SEER) data (1999–2003) was conducted. Overall survival (OS) and lung cancer‐specific survival (LCSS) univariate analyses were conducted using the Kaplan‐Meier method. Multivariate survival analyses were performed using Cox proportional hazards ratios. RESULTS. A total of 27,435 incident cases of histologically confirmed, advanced stage NSCLC were identified. Cases with stage IIIB NSCLC due to multiple lesions in the same lobe (n = 633) had a significantly improved median OS (21 months) and LCSS (31 months) compared with other cases with stage IIIB NSCLC (n = 7695), with an OS of 7 months and an LCSS of 9 months (P < .0001 for both comparisons). Among cases with stage IV NSCLC, those with intrapulmonary nodules (n = 3010) had a significantly improved median OS (9 months) and LCSS (10 months) compared with those with distant metastasis (n = 16,097), with an OS of 4 months and an LCSS of 5 months (P < .0001 for both comparisons). These survival differences persisted after adjustment for age, sex, ethnicity, surgery, and radiotherapy. Among cases with stage IV NSCLC, those with ipsilateral intrapulmonary nodules (n = 1120) had improved OS (12 months) compared with those with bilateral intrapulmonary nodules (n = 1890), with an OS of 7 months (P < .0001). CONCLUSIONS. Cases with stage IIIB and IV NSCLC with ipsilateral intrapulmonary nodules were found to have improved survival outcomes compared with other cases with stage IIIB and IV disease. The results of the current study add additional support for modifications to the current NSCLC staging system. Cancer 2008. © 2007 American Cancer Society.

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“…A retrospective study from Singapore [24] observed no differences in response rates between current and former smokers, finding respective median survival times of 18.5 and 13.6 months (p = .14). In another study, Nordquist et al [25] reported a 5-year survival rate of 23% for patients with adenocarcinoma of the lung who had never smoked (neversmokers), compared with 16% for smokers (p = .004).…”

Section: Thementioning

confidence: 98%

Clinical Evidence for Second- and Third-Line Treatment Options in Advanced Non-Small Cell Lung Cancer

Marinis

Grossi²

2008

The Oncologist

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In the U.S. and Europe, the current options for the second-and third-line treatment of advanced non-small cell lung cancer (NSCLC) are cytotoxic drugs and targeted agents. Docetaxel was the first drug approved for second-line treatment after two phase III trials demonstrated its superiority over best supportive care (BSC) alone and single-agent chemotherapy. Pemetrexed was also registered for use as second-line therapy after it was demonstrated to have activity comparable with, and a more favorable toxicity profile than, docetaxel. Erlotinib, an epidermal growth factor receptor inhibitor, is the only biological agent to have been approved in the U.S. and Europe for lung cancer treatment after a study showed its superiority over BSC in recurrent (second-/third-line) NSCLC patients. This review focuses on these drugs, dealing with the results supporting the choice among docetaxel, pemetrexed, and erlotinib in second-and/or third-line treatment. The Oncologist 2008;13(suppl 1):14-20

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Improved Survival in Never-Smokers vs Current Smokers With Primary Adenocarcinoma of the Lung

Cited by 205 publications

References 12 publications

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

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

Survival improvements for advanced stage nonbronchioloalveolar carcinoma‐type nonsmall cell lung cancer cases with ipsilateral intrapulmonary nodules

Clinical Evidence for Second- and Third-Line Treatment Options in Advanced Non-Small Cell Lung Cancer

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