Wolf M, Holle R, Hans K, Drings P, Havemann K
Department of Internal Medicine, Philipps-University of Marburg, Germany.
Br J Cancer. 1991 Jun;63(6):986-92. doi: 10.1038/bjc.1991.215.
The data of 766 patients participating in three German multicentre trials were analysed with regard to the relationship between baseline characteristics and prognosis in small cell lung cancer (SCLC). The central aim of this analysis has been to evaluate the role of gender as an independent prognostic factor in SCLC. The minimum follow-up period for the 652 male and 114 female patients was 36 months. Female patients were shown to have a higher complete remission rate (35% vs 25%), a superior median survival (ms) (12.1 months (mo) vs 9.8 mo), and a favourable 2-year survival rate (2ys) (19% vs 8%) to male ones. Various other prognostic factors have been proved to be significant, such as extent of disease, clinical performance status, and history of smoking, whereas weight loss prior to chemotherapy and age have been less important factors. We have been able to ascertain that women's responses were better than those of male patients independent of any other relevant prognostic variable. Furthermore, results were found to be even more advantageous for female patients with additional favourable prognostic parameters, i.e. for patients with limited disease (ms 15.2 mo vs 12.0 mo; 2ys 29% vs 9%) or with good performance status (ms 13.4 mo vs 10.4 mo; 2ys 24% vs 7%). A most remarkable observation was made in that the favourable prognostic effect of the female gender was restricted to patients aged less than 60 years (ms 13.3 mo vs 10.1 mo; 2ys 26% vs 5%), whereas for older women no advantages over men's results were established (ms 9.3 ml vs 9.1 mo; 2ys 8% vs 7%). A proportion of 32% of female patients with limited disease aged less than 60 years achieved a 3-year survival rate. We conclude (a) that sex constitutes a major prognostic factor in SCLC and is especially useful as a predictor for long-term survival, and (b) that the favourable prognostic value of the female sex is restricted to younger patients.
对参与三项德国多中心试验的766例患者的数据进行了分析，以研究小细胞肺癌（SCLC）的基线特征与预后之间的关系。该分析的主要目的是评估性别作为SCLC独立预后因素的作用。652例男性患者和114例女性患者的最短随访期为36个月。结果显示，女性患者的完全缓解率更高（35%对25%），中位生存期（ms）更长（12.1个月（mo）对9.8 mo），2年生存率（2ys）更优（19%对8%）。已证明其他各种预后因素也具有显著性，如疾病范围、临床性能状态和吸烟史，而化疗前体重减轻和年龄则是不太重要的因素。我们已经确定，女性患者的反应优于男性患者，且不受任何其他相关预后变量的影响。此外，对于具有其他有利预后参数的女性患者，即疾病局限的患者（ms 15.2 mo对12.0 mo；2ys 29%对9%）或性能状态良好的患者（ms 13.4 mo对10.4 mo；2ys 24%对7%），结果更为有利。一个最显著的发现是，女性性别的有利预后作用仅限于年龄小于60岁的患者（ms 13.3 mo对10.1 mo；2ys 26%对5%），而对于老年女性，未发现优于男性的结果（ms 9.3 ml对9.1 mo；2ys 8%对7%）。年龄小于60岁、疾病局限的女性患者中有32%达到了3年生存率。我们得出结论：（a）性别是SCLC的一个主要预后因素，尤其作为长期生存的预测指标很有用；（b）女性性别的有利预后价值仅限于年轻患者。
