Department of Internal Medicine, University of Manitoba, Manitoba, Canada.
Can Respir J. 2013 Jan-Feb;20(1):30-4. doi: 10.1155/2013/618691.
Males with non-small cell lung cancer (NSCLC) tend to experience worse outcomes, as do those with nonadenocarcinoma histology; however, the independent effects of these factors remain unclear.
To evaluate the independent effect of sex and histology on mortality in a population of patients with NSCLC.
All patients with NSCLC in Manitoba from 1985 to 2004 were identified from the Manitoba Cancer Registry. Treatment data were extracted from the Manitoba Health administrative databases and linked to the registry. Cox regression analysis was used to determine the independent effect of sex on survival.
A total of 10,908 patients (6665 male, 4243 female) with NSCLC were identified. Females had a median overall survival of 9.4 months versus 6.8 months for males (P<0.001). The adjusted HR for death for males compared with females was 1.13 (95% CI 1.04 to 1.23; P=0.004). Sex modified the effect of surgical treatment on survival (HR 1.26 [95% CI 1.13 to 1.40]; P<0.001). Adenocarcinoma histology modified the effect of sex on survival (HR 1.36 [95% CI 1.24 to 1.50]; P<0.001) when treatment was accounted for.
Females experienced a significantly better survival rate than males independent of treatment, age, year of diagnosis and histology. This was greatest in surgically treated patients and in those with adenocarcinoma.
非小细胞肺癌（NSCLC）男性患者的预后往往较差，非腺癌组织学类型也是如此；然而，这些因素的独立影响仍不清楚。
评估在非小细胞肺癌患者人群中，性别和组织学对死亡率的独立影响。
从曼尼托巴癌症登记处确定了 1985 年至 2004 年期间所有在曼尼托巴的 NSCLC 患者。从曼尼托巴健康管理数据库中提取治疗数据，并与登记处进行链接。Cox 回归分析用于确定性别对生存的独立影响。
共确定了 10908 例（6665 例男性，4243 例女性）非小细胞肺癌患者。女性的中位总生存期为 9.4 个月，而男性为 6.8 个月（P<0.001）。与女性相比，男性死亡的调整 HR 为 1.13（95%CI 1.04 至 1.23；P=0.004）。性别改变了手术治疗对生存的影响（HR 1.26 [95%CI 1.13 至 1.40]；P<0.001）。当考虑治疗时，腺癌组织学改变了性别对生存的影响（HR 1.36 [95%CI 1.24 至 1.50]；P<0.001）。
无论治疗、年龄、诊断年份和组织学类型如何，女性的生存率都明显高于男性。在接受手术治疗的患者和腺癌患者中，这种差异最大。
