Rshaidat Hamza, Madeka Isheeta, Whitehorn Gregory L, Martin Jonathan, Mack Shale J, Alaparthi Sneha, Grenda Tyler R, Evans Nathaniel R, Okusanya Olugbenga T
Division of Esophageal and Thoracic Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pa.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa.
JTCVS Open. 2025 Feb 12;24:438-450. doi: 10.1016/j.xjon.2024.12.015. eCollection 2025 Apr.
Female sex has been associated with improved survival after lung cancer resection. Our aim is to use a national database to describe sex disparities in early lung cancer treatment and evaluate whether outcomes of ethnic groups who traditionally have poorer outcomes are attenuated by female sex.
This is a retrospective cohort study using the 2020 National Cancer Database. Adult patients diagnosed between 2010 and 2019 with early-stage non-small cell lung cancer (clinical T1 or T2, N0, M0) who received surgical resection with a known vital status were included. Patients who received neoadjuvant systemic or radiation therapy were excluded. Demographic data; clinicopathologic variables; 30-day, 90-day, 5-year mortality; and 5-year overall survival were analyzed.
We identified 192,927 patients with surgically resected early-stage non-small cell lung cancer. Mean patient age was 69 years (interquartile range, 62-75). Five-year overall survival among women was 72.8% versus 60.4% in men ( < .001), with the largest difference between Asian Pacific Islander women and men. Among women, White and Black women had the lowest 5-year overall survival. White and Black women had a higher 5-year overall survival than White, Black, Hispanic, and Other men.
Female sex was associated with improved overall survival in patients with early-stage lung cancer regardless of ethnicity. However, there is significant variation between ethnic groups in the absolute size of this association. Additional studies are necessary to determine which factors contribute to this disparity, including but not limited to biological, clinical, and health-systems related.
女性与肺癌切除术后生存率提高相关。我们的目的是利用国家数据库描述早期肺癌治疗中的性别差异，并评估传统上预后较差的种族群体的预后是否因女性性别而得到改善。
这是一项使用2020年国家癌症数据库的回顾性队列研究。纳入2010年至2019年间诊断为早期非小细胞肺癌（临床T1或T2，N0，M0）且接受手术切除且已知生命状态的成年患者。排除接受新辅助全身治疗或放射治疗的患者。分析人口统计学数据、临床病理变量、30天、90天、5年死亡率和5年总生存率。
我们确定了192,927例接受手术切除的早期非小细胞肺癌患者。患者平均年龄为69岁（四分位间距，62 - 75岁）。女性的5年总生存率为72.8%，而男性为60.4%（<0.001），亚太岛民女性和男性之间的差异最大。在女性中，白人和黑人女性的5年总生存率最低。白人和黑人女性的5年总生存率高于白人、黑人、西班牙裔和其他男性。
无论种族如何，女性性别与早期肺癌患者的总生存率提高相关。然而，不同种族群体之间这种关联的绝对大小存在显著差异。需要进一步研究以确定哪些因素导致了这种差异，包括但不限于生物学、临床和卫生系统相关因素。
