Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey.
Department of Medical Oncology Outpatient Clinic, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Oncol Res Treat. 2024;47(9):401-409. doi: 10.1159/000540244. Epub 2024 Jul 22.
Several previous studies have explored whether sex has prognostic significance in patients with small cell lung cancer (SCLC). In this retrospective study, we aimed to show the clinical significance of sex in SCLC patients.
A total of 378 SCLC patients were assessed retrospectively.
Sixty-one (16.1%) patients were women; 26 of 131 (19.9%) patients had limited disease (LD-SCLC); and 14.2% of patients (35 of 247 patients) had extended disease (ED-SCLC). In all SCLC patients, regardless of stage, female patients were more likely to be nonsmokers (7.7 vs. 1%, p = 0.04 for LD-SCLC; and 11.4 vs. 1.4%, p = 0.001 for ED-SCLC) and more often to be anemic (26.9 vs. 11.4%, p = 0.04 for LD-SCLC; and 45.7 vs. 28%, p = 0.03 for ED-SCLC). While women with LD-SCLC were diagnosed younger (<60) than men (65.4 vs. 37.1%, p = 0.009), they had larger (>5 cm) tumors (69.2 vs. 42.9%, p = 0.01). Moreover, obesity (77.1 vs. 56.4%, p = 0.02) and less weight loss (88.6 vs. 73.6%, p = 0.04) were more common in women with ED-SCLC than in men. However, there were no associations between sex and significant prognostic factors, such as performance status, metastasis site, serum LDH level, response to chemotherapy, and disease recurrence. Outcomes in LD-SCLC patients were found to be similar between sexes; median overall survivals in women compared to men was 18 versus 15 months, respectively (p = 0.8). On the other hand, female patients with ED-SCLC had better survivals; median survivals for women versus men were 10 versus 7 months, respectively (p = 0.008). This significance for female ED-SCLC patients was also maintained in the multivariate analysis (p = 0.001).
While the survival rates of female patients, who constitute a small proportion of SCLC patients, are no different from men in LD-SCLC, they are better in ED-SCLC.
已有几项研究探讨了性别在小细胞肺癌（SCLC）患者中的预后意义。在这项回顾性研究中，我们旨在展示性别的临床意义。
对 378 例 SCLC 患者进行回顾性评估。
61 例（16.1%）患者为女性；131 例患者中有 26 例（19.9%）为局限性疾病（LD-SCLC）；14.2%的患者（247 例患者中有 35 例）为广泛期疾病（ED-SCLC）。在所有 SCLC 患者中，无论分期如何，女性患者更有可能是非吸烟者（7.7%对 1%，p=0.04 用于 LD-SCLC；11.4%对 1.4%，p=0.001 用于 ED-SCLC）且更常贫血（26.9%对 11.4%，p=0.04 用于 LD-SCLC；45.7%对 28%，p=0.03 用于 ED-SCLC）。与男性相比，患有 LD-SCLC 的女性患者诊断时更年轻（<60 岁，65.4%对 37.1%，p=0.009），肿瘤更大（>5cm，69.2%对 42.9%，p=0.01）。此外，肥胖（77.1%对 56.4%，p=0.02）和体重减轻较少（88.6%对 73.6%，p=0.04）在 ED-SCLC 女性中更为常见。然而，性别与显著的预后因素（如表现状态、转移部位、血清 LDH 水平、对化疗的反应和疾病复发）之间没有关联。LD-SCLC 患者的结局在性别之间相似；女性的中位总生存时间与男性相比为 18 个月与 15 个月（p=0.8）。另一方面，患有 ED-SCLC 的女性患者的生存率更好；女性与男性的中位生存时间分别为 10 个月与 7 个月（p=0.008）。这一意义在多变量分析中也得到了维持（p=0.001）。
尽管构成 SCLC 患者一小部分的女性患者的生存率在 LD-SCLC 中与男性没有不同，但在 ED-SCLC 中则更好。
