Copeland Jessica, Farooq Tayyiaba, Phillips Sophia, Blehm Taelyr, Drew Grace, Orav Endel
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass.
Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ.
JTCVS Open. 2025 Apr 10;25:406-414. doi: 10.1016/j.xjon.2025.03.022. eCollection 2025 Jun.
Sex-based overall survival in patients with early-stage non-small cell lung cancer who undergo surgery is not well characterized. Existing data are limited by small sample sizes and underrepresentation of female patients or do not address overall survival according to surgical approach. The objective of this study was to compare overall survival among female and male patients with early-stage non-small cell lung cancer who underwent surgery.
Data were extracted from the National Cancer Database for all patients diagnosed with clinical stage I-IIB non-small cell lung cancer who underwent surgical resection from 2009 to 2018, had R margins, and had at least 10 lymph nodes sampled for metastasis. Overall survival of the study sample was evaluated based on sex using multivariable Cox proportional hazards modeling and propensity score-matched analysis.
Of the 79,209 patients included in the study sample, 43,218 (54.6%) were female. A propensity score-matched analysis of 23,988 female and 23,988 male patients with early-stage non-small cell lung cancer who underwent surgery showed that the female group had significantly improved 5-year overall survival at 71.2% (95% CI, 70.5-71.8) compared with the male group at 61.7% (95% CI, 61.0-62.4) (log-rank, < .0001).
Female patients with early-stage non-small cell lung cancer who underwent surgery had significantly better overall survival at 5 years when compared with their male counterparts.
接受手术治疗的早期非小细胞肺癌患者的性别相关总生存率尚未得到充分描述。现有数据受样本量小和女性患者代表性不足的限制，或者未根据手术方式探讨总生存率。本研究的目的是比较接受手术治疗的早期非小细胞肺癌女性和男性患者的总生存率。
从国家癌症数据库中提取2009年至2018年期间诊断为临床I-IIB期非小细胞肺癌、接受手术切除、切缘阴性且至少采集10个淋巴结用于转移检测的所有患者的数据。使用多变量Cox比例风险模型和倾向评分匹配分析，根据性别评估研究样本的总生存率。
研究样本中的79209例患者中，43218例（54.6%）为女性。对23988例接受手术的早期非小细胞肺癌女性患者和23988例男性患者进行倾向评分匹配分析，结果显示女性组5年总生存率显著提高，为71.2%（95%CI，70.5-71.8），而男性组为61.7%（95%CI，61.0-62.4）（对数秩检验，P<0.0001）。
接受手术治疗的早期非小细胞肺癌女性患者的5年总生存率显著高于男性患者。
