Role of gender in the survival of surgical patients with nonsmall cell lung cancer

Scaglia, Nóris Coimbra; Chatkin, José Miguel; Pinto, Josuel Alfredo Vilela; Tsukazan, Maria Teresa Ruiz; Wagner, Mário Bernardes; Saldanha, Adriana F.

doi:10.4103/1817-1737.114297

Cited by 13 publications

(4 citation statements)

References 27 publications

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“…Our patient sample pool also indicated that there were similar numbers of adenocarcinoma and squamous cell carcinoma histological types (11 cases each). Although it is known that adenocarcinoma is the most common histological tumor type found in large centers in the U.S. and Europe [ 14 , 15 ], squamous cell carcinoma is still the most common type in Brazil despite the gradual narrowing of the difference in frequency between them in recent years [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Lung cancer with chest wall invasion: retrospective analysis comparing en-bloc resection and ‘resection in bird cage’

Santos

Lopes

Higa

et al. 2014

J Cardiothorac Surg

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BackgroundInvasion of the chest wall per se is not a contraindication for tumor resection in non-small cell lung cancer (NSCLC), provided there is no mediastinal lymph node or vital structure involvement. Although widely known to Brazilian surgeons, the ‘resection in bird cage’ technique has never been widely studied in terms of patient survival. Thus, the objective of this study was to evaluate the postoperative consequences and overall survival of extra-musculoperiosteal resection compared with en-bloc resection in NSCLC patients with invasion of the endothoracic fascia.MethodsBetween January 1990 and December 2009, 33 NSCLC patients with invasion of the thoracic wall who underwent pulmonary resection were retrospectively analyzed. Of the 33 patients evaluated, 20 patients underwent en-bloc resection and 13 underwent ‘resection in bird cage.’ For each patient, a retrospective case note review was made.ResultsThe median age at surgery, gender, indication, rate of comorbidities, tumor size and the degree of uptake in the costal margin were similar for both groups. The rate of postoperative complications and the duration of hospitalization did not differ between the groups. Regarding the outcome variables, the disease-free interval, rate of local recurrence, metastasis-free time after surgery, overall mortality rate, mortality rate related to metastatic disease, duration following surgery in which deaths occurred, and overall survival were also similar between groups. The cumulative survival curves between the ‘resection in bird cage’ and en-bloc resection and between stages Ia + Ib and IIb + IIIa + IV were not significantly different (p = 0.68 and p = 0.64, respectively). The cumulative metastasis-free survival curves were not significantly different between the two types of surgery (p = 0.38).ConclusionsIn NSCLC patients with invasion of the endothoracic fascia, ‘resection in bird cage’ is a less aggressive procedure that yields similar results in terms of morbidity and mortality compared with en-bloc resection. Thus, ‘resection in bird cage’ meets the oncologic principles of resection and does not adversely affect the patients in terms of cure.

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Section: Discussionmentioning

confidence: 99%

Lung cancer with chest wall invasion: retrospective analysis comparing en-bloc resection and ‘resection in bird cage’

Santos

Lopes

Higa

et al. 2014

J Cardiothorac Surg

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“…[13][14][15][16] Most studies have reported that female sex is an independent favorable prognostic factor for lung cancer, yet there are also varying opinions. [17][18][19][20][21] Among the latter, some studies have found no sex-specific survival difference after surgical resection for early stage non-small cell lung cancer (NSCLC) patients; 19,21 others have found that when follow-up time exceeds five years, although there is a separation in the survival curves between sexes within early years, long-term survival rates are similar, especially after five years. 20 As the survival time of lung cancer patients becomes progressively longer, it is doubtful whether the effect of sex on prognosis is still consistent.…”

Section: Introductionmentioning

confidence: 99%

“…[17][18][19][20][21] Among the latter, some studies have found no sex-specific survival difference after surgical resection for early stage non-small cell lung cancer (NSCLC) patients; 19,21 others have found that when follow-up time exceeds five years, although there is a separation in the survival curves between sexes within early years, long-term survival rates are similar, especially after five years. 20 As the survival time of lung cancer patients becomes progressively longer, it is doubtful whether the effect of sex on prognosis is still consistent. It is therefore necessary to further explore exactly what patient characteristics will have sex prognostic differences and whether they change over time.…”

Section: Introductionmentioning

confidence: 99%

Time‐varying effect of sex on prognosis of lung adenocarcinoma surgical patients in China

Wang

Zhou

et al. 2021

Thoracic Cancer

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Background: Little is known about the prognostic advantage of sex for pulmonary adenocarcinoma among Chinese patients. In this study, we aimed to investigate the true sex differences in prognosis by adjusting for confounders and to explore whether the differences were time-varying. Methods: We identified 4438 lung adenocarcinoma patients who underwent surgery at a regional Cancer Center of China from 2008 to 2016, retrospectively. Sex, age group, smoking history, year of diagnosis and pathological stage were collected. Time-dependent Cox regression models with inverse probability of treatment weighting (IPTW) based on propensity score were used to assess the effect of sex and account for confounders. Landmark analyses were conducted to assess survival before, and after, five years. Results: Of these patients, 1761 (39.7%) were men and 2677 (60.3%) were women. Median follow-up time was 52.6 months. After IPTW adjustment, women were found to have significantly better survival than men varying with time in both crude and IPTW models (hazard ratio [HR] [t] = 0.453*1.015 t , where t is the length of time from treatment and its unit is month, p < 0.001). Women had significantly better survival than men within 0-5 years after surgery (HR = 0.763, 95% CI: 0.649-0.897, p = 0.001), whereas there was no difference after five years (HR = 1.135, 95% CI: 0.803-1.605, p = 0.472). In subgroup analysis, women in the 61-71+ age group, in the more than 20 year packs group, pathological stage 0-IB group, and 2013-2016 diagnosis period group revealed the same prognostic pattern. Conclusions: Compared with men, women had better survival after surgical resection of lung adenocarcinoma, especially those who were older and nonsmokers or heavy-smokers and were pathological stage 0-IB in early years, while the advantage for women diminished with time.

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“…Moreover, women are more likely to receive molecular targeted therapy compared to men (Graham et al, 2013). Some studies have shown that being female acts as a possible protective factor for non-small cell lung cancer (NSCLC) survival (Nakamura et al, 2011;Scaglia et al, 2013), while one study (Minami et al, 2000) suggested that this effect is only confined to older, postmenopausal women. Women over the age of 60 showed a distinct survival advantage relative to men and younger women.…”

Section: Introductionmentioning

confidence: 99%

Roles of ERα and ERβ in estrogen-induced DDP chemoresistance in non-small cell lung cancer

Dou

et al. 2016

Genet. Mol. Res.

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ABSTRACT. The role of estrogen in inducing chemoresistanceis not yet fully understood. The objective of this study was to observe the relationship between estrogen levels and cellular response to chemotherapeutic drugs in non-small cell lung cancer (NSCLC) and to reveal the potential mechanisms involved. Cell viability was analyzed after pre-treating NSCLC cells with different levels of estrogen (E2), followed by treatment with an anti-tumor drug for 48 h. The roles of various estrogen receptors (ERs) were examined in vitro by blocking the activity of each ER individually. The ER pathway was further confirmed in NSCLC tissues. It was found that 10-1000 nM E2 resulted in a decreased cellular response to DDP in H1650 cells compared to the use of cisplatin alone (P < 0.05). However, this result was not demonstrated in H1299 cells, which lack p53. Both ERa and ERb were associated with E2-induced cisplatin chemoresistance, though they had opposite functions. p53 expression did not correlate with the expression of ERa or ERb individually. However, a statistically significant correlation between p53 expression and ERa to ERb mRNA ratio was observed (P < 0.001, R = -0.676). These findings suggest that E2-induced DDP chemoresistance depends on the balance between ERa and ERb expression and the p53 pathway.

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Role of gender in the survival of surgical patients with nonsmall cell lung cancer

Cited by 13 publications

References 27 publications

Lung cancer with chest wall invasion: retrospective analysis comparing en-bloc resection and ‘resection in bird cage’

Lung cancer with chest wall invasion: retrospective analysis comparing en-bloc resection and ‘resection in bird cage’

Time‐varying effect of sex on prognosis of lung adenocarcinoma surgical patients in China

Roles of ERα and ERβ in estrogen-induced DDP chemoresistance in non-small cell lung cancer

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