Women With Pathologic Stage I, II, and III Non-small Cell Lung Cancer Have Better Survival Than Men

Cerfolio, Robert J.; Bryant, Ayesha S.; Scott, E. W.; Sharma, Manisha; Robert, Francisco; Spencer, Sharon A.; Garver, Robert I.

doi:10.1378/chest.130.6.1796

Cited by 127 publications

(101 citation statements)

References 27 publications

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“…Several patient factors are associated with lower odds of undergoing a potentially curative treatment for lung cancer. Higher age is the most important factor, but in studies from the United States as well as Europe gender, comorbidity, race, socio-economic status, region or country of origin have also proven to be predictive (17)(18)(19)(20)(21)(22). These inequalities are not only due to decreased access to care, but also differences in physicians' treatment choices and differences in guideline implementation and adherence are believed to be of influence.…”

Section: Discussionmentioning

confidence: 99%

Variation in treatment and outcome in patients with non-small cell lung cancer by region, hospital type and volume in the Netherlands

Wouters

Siesling

Jansen-Landheer

et al. 2010

European Journal of Surgical Oncology (EJSO)

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Section: Discussionmentioning

confidence: 99%

Variation in treatment and outcome in patients with non-small cell lung cancer by region, hospital type and volume in the Netherlands

Wouters

Siesling

Jansen-Landheer

et al. 2010

European Journal of Surgical Oncology (EJSO)

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“…(9,11,21) In such cases, the probability of patients whose tumors were resected presenting temporary cure ranges from 60% to 80%, rates were found to be 15.5%, 10.8%, 14% and 18.75%, respectively. Therefore, it is possible to observe that lung cancer is an extremely aggressive type of cancer, with low survival rates.…”

Section: Resultsmentioning

confidence: 99%

“…However, in recent decades, adenocarcinoma, which is the histological type with the best prognosis among women, (21) has presented an increasing incidence, surpassing that of the squamous type in various studies in the literature. (15) Studies have concluded that the increased incidence of the former was due to changes in smoking behavior and in the type of cigarettes.…”

Section: Months)mentioning

confidence: 99%

Características de pacientes com câncer de pulmão na cidade de Manaus

Westphal

Lima

Andrade³

et al. 2009

J. bras. pneumol.

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Objective: To analyze the characteristics of patients with lung cancer. Methods: A retrospective descriptive study of patients receiving a histopathological diagnosis of lung cancer between 1995 and 2002 in the city of Manaus, Brazil. Data were collected from the medical archives of three hospitals. Statistical analyses were carried out, and survival curves were generated by means of an actuarial estimator. Results: Of the 352 patients selected, 262 (74.4%) were male and 90 (25.6%) were female. The mean age was 62 years. The following histological types were identified: squamous cell carcinoma, 62.8%; adenocarcinoma, 24.7%; small cell carcinoma, 9.1%; and large cell carcinoma, 3.4%. The most common stages were stages IIIB and IV, in 45% and 21.5%, respectively. Of the total sample, 73.4% were submitted to treatment. Of these, 51.4% underwent radiotherapy; 16.6%, surgery; 15.8%, chemotherapy; and 16.2%, radiotherapy in association with chemotherapy. Cumulative survival rates were low: three-year survival was 6.5%, and five-year survival was 3.5%. Conclusions: In this group of patients with lung cancer, survival rates were considerably lower than those reported in the literature. This might be attributable to the limited access to the specialized health care system and the advanced stage of the disease at diagnosis.Keywords: Lung neoplasms; Neoplasm staging; Survival. ResumoObjetivo: Analisar as características de pacientes com câncer de pulmão. Métodos: Estudo retrospectivo e descritivo dos pacientes com diagnóstico histopatológico de câncer de pulmão entre 1995 e 2002 em Manaus (AM). Os dados dos pacientes foram coletados nos arquivos médicos de três hospitais. As análises estatísticas foram realizadas, e as curvas de sobrevida geradas a partir do estimador atuarial. Resultados: Dos 352 pacientes selecionados, 262 (74,4%) eram do sexo masculino e 90 (25,6%) do feminino. A média de idade foi de 62 anos. Os seguintes tipos histológicos foram encontrados: carcinoma de células escamosas, 62,8%; adenocarcinoma, 24,7%; carcinoma de pequenas células, 9,1%; e carcinoma de grandes células, 3,4%. Os estádios IIIB e IV foram os mais comuns, com uma frequência de 45% e 21,5%, respectivamente. Da amostra total, 73,4% foram submetidos a tratamento. Desses, 51,4% foram submetidos à radioterapia; 16,6%, à cirurgia; 15,8%, à quimioterapia; e 16,2%, à radioterapia associada à quimioterapia. Os níveis de sobrevida acumulada foram baixos: a sobrevida em três anos foi de 6,5% e a sobrevida em cinco anos foi de 3,5%. Conclusões: Este grupo de pacientes com câncer de pulmão apresentou uma sobrevida muito pequena, divergindo dos resultados encontrados na literatura. Isto é provavelmente decorrente da dificuldade de acesso ao sistema de saúde especializado e do estágio avançado do diagnóstico.Descritores: Neoplasias pulmonares; Estadiamento de neoplasias; Sobrevivência.* Study carried out at the Federal University of Amazonas, Manaus, Brazil.

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“…Gender-related disparity in outcomes of patients with NSCLC, even after adjustment for age, stage and treatment, has long been a subject of debate [Chansky et al 2009;Cerfolio et al 2006]. A consistent difference exists in the distribution of NSCLC histological types, with adenocarcinoma and squamous-cell carcinoma being the most common histology in women and men, respectively.…”

Section: Associations Of Clinicopathological Features With Molecular mentioning

confidence: 99%

How close are we to customizing chemotherapy in early non-small cell lung cancer?

2011

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Although surgery is the only potentially curative treatment for early-stage non-small cell lung cancer (NSCLC), 5-year survival rates range from 77% for stage IA tumors to 23% in stage IIIA disease. Adjuvant chemotherapy has recently been established as a standard of care for resected stage II-III NSCLC, on the basis of large-scale clinical trials employing third-generation platinum-based regimens. As the overall absolute 5-year survival benefit from this approach does not exceed 5% and potential long-term complications are an issue of concern, the aim of customized adjuvant systemic treatment is to optimize the toxicity/ benefit ratio, so that low-risk individuals are spared from unnecessary intervention, while avoiding undertreatment of high-risk patients, including those with stage I disease. Therefore, the application of reliable prognostic and predictive biomarkers would enable to identify appropriate patients for the most effective treatment.This is an overview of the data available on the most promising clinicopathological and molecular biomarkers that could affect adjuvant and neoadjuvant chemotherapy decisions for operable NSCLC in routine practice. Among the numerous candidate molecular biomarkers, only few gene-expression profiling signatures provide clinically relevant information warranting further validation. On the other hand, real-time quantitative polymerase-chain reaction strategy involving relatively small number of genes offers a practical alternative, with high cross-platform performance. Although data extrapolation from the metastatic setting should be cautious, the concept of personalized, pharmacogenomics-guided chemotherapy for early NSCLC seems feasible, and is currently being evaluated in randomized phase 2 and 3 trials. The mRNA and/or protein expression levels of excision repair cross-complementation group 1, ribonucleotide reductase M1 and breast cancer susceptibility gene 1 are among the most potential biomarkers for early disease, with stage-independent prognostic and predictive values, the clinical utility of which is being validated prospectively. Inter-assay discordance in determining the biomarker status and association with clinical outcomes is noteworthing.

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Women With Pathologic Stage I, II, and III Non-small Cell Lung Cancer Have Better Survival Than Men

Cited by 127 publications

References 27 publications

Variation in treatment and outcome in patients with non-small cell lung cancer by region, hospital type and volume in the Netherlands

Variation in treatment and outcome in patients with non-small cell lung cancer by region, hospital type and volume in the Netherlands

Características de pacientes com câncer de pulmão na cidade de Manaus

How close are we to customizing chemotherapy in early non-small cell lung cancer?

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