The effect of orchiectomy on lung cancer survival.

Gender is an independent prognostic factor for survival from lung cancer with the relative risk of lung cancer death for men compared to women being 1.3. This observation remains unexplained but in vitro data suggests a stimulatory effect of androgens on lung cancer growth. We hypothesized that androgen deprivation improves survival in men with lung cancer compared to hormonally intact men with lung cancer. On the basis of age, race and region, we matched 44 men with lung cancer and bilateral orchiectomy with 88 men who had lung cancer and no history of orchiectomy and compared their survival. Since hazards were non-proportional we chose the generalized gamma model to describe the survival function. The survival was significantly different between the two groups (p = 0.0048) with the orchiectomy group having a better two year overall survival. This retrospective study suggests that androgen depletion may significantly improve the short term survival of men with lung cancer but further, prospective investigation is required for confirmation.