title: The prognostic impact of sex on surgically resected non-small cell lung cancer depends on clinicopathologic characteristics.
abstract: The increasing incidence of lung cancer in women and their supposed survival advantage over men requires clarification of the significance of sex. Age, stage, histologic features, differentiation grade, and Ki-67 index were assessed in 405 surgically resected non-small cell lung cancers (NSCLCs) using a standardized tissue microarray platform. Women were associated with well/moderate tumor differentiation, a Ki-67 index of 3% or less, and adenocarcinoma histologic features. Female sex predicted increased survival time only by univariate analysis. Stratified by sex, increased survival was noted for women older than 64 years, with a tumor at postsurgical International Union Against Cancer stage I, with adenocarcinoma histologic features, with well- or moderately differentiated tumors, or with a Ki-67 index of 3% or less. Sex is not an independent prognostic parameter for patients with surgically resected NSCLC. Sex-linked differences are associated with other factors, thus simulating a prognostic impact of sex. This study elucidates sex-specific interactions between patient and tumor characteristics, which are pivotal toward improving prognostic accuracy, individualized therapies, and screening efforts.
authors.affiliation: Institute for Pathology, Academic Hospital Feldkirch, Affiliation of the Medical University Innsbruck, Feldkirch, Austria.
authors.forename: William
authors.initials: W
authors.lastname: Sterlacci
authors.forename: Alexandar
authors.initials: A
authors.lastname: Tzankov
authors.forename: Lothar
authors.initials: L
authors.lastname: Veits
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Oberaigner
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmid
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hilbe
authors.forename: Michael
authors.initials: M
authors.lastname: Fiegl
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D014408:Biomarkers, Tumor / Q000378:metabolism; D018196:Carcinoma, Adenosquamous / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D018287:Carcinoma, Large Cell / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D018277:Carcinoma, Mucoepidermoid / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D002296:Carcinosarcoma / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008168:Lung / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012737:Sex Factors; D015996:Survival Rate; D046888:Tissue Array Analysis; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen