title: Non-small cell lung cancer in surgically treated women.
abstract: OBJECTIVE
  To determine whether female patients operated on for non-small cell lung cancer (NSCLC) have a survival advantage compared to male patients.
  
  
  METHODS
  We analyzed data from 1,426 prospectively collected patients submitted to lung resection for NSCLC between 1999 and 2008.
  
  
  RESULTS
  Two groups, including 1,014 male and 412 female patients, were compared. Female patients were significantly younger, were more frequently asymptomatic, were less likely to be smokers, had better preoperative respiratory function, had a lower frequency of COPD, and were less commonly affected by cardiovascular comorbidity than men. Adenocarcinoma was more frequently present and early pathological stage (stage IA) more frequently detected in women at diagnosis. The operative mortality was significantly lower among women (1.6% vs 4.6%) (P = 0.012), and women underwent significantly more segmentectomies and fewer pneumonectomies (P = 0.001). The disease-related 5-year survival rate was significantly higher in women (66% vs 51%) (P = 0.0008). At univariate analysis the absence of symptoms at presentation, lower pathological stage, squamous cell type, and female gender were positive factors influencing long-term survival. At multivariate analysis low pathological stage, squamous cell type and female gender were confirmed as independent positive prognostic predictors. Women had a significant survival advantage irrespective of the histological subtype at pathological stage IA, IB, IIB and IIIA disease (P <0.05).
  
  
  CONCLUSIONS
  Female gender was confirmed to be a particular subset amongst patients affected by NSCLC and exerted a positive effect on disease-related survival of patients submitted to surgical resection. This important effect of gender should be cautiously kept in mind in analyzing the results of current and future trials for lung cancer therapy.
authors: Ottavio
authors: O
authors: Rena
authors: Fabio
authors: F
authors: Massera
authors: Renzo
authors: R
authors: Boldorini
authors: Esther
authors: E
authors: Papalia
authors: Davide
authors: D
authors: Turello
authors: Fabio
authors: F
authors: Davoli
authors: Guido
authors: G
authors: Baietto
authors: Alberto
authors: A
authors: Roncon
authors: Mario
authors: M
authors: Robustellini
authors: Caterina
authors: C
authors: Casadio
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000601:surgery; D000368:Aged; D018287:Carcinoma, Large Cell / Q000453:epidemiology / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000601:surgery; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011446:Prospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D016019:Survival Analysis