Non-Small Cell Lung Cancer in Women: A Distinct Entity?

Authors

  • Umut Kefeli Medeniyet University Goztepe Education and Training Hospital
  • Bala Basak Oven Ustaalioglu Haydarpasa Numune Education and Training Hospital
  • Burcak Yılmaz Haydarpasa Numune Education and Training Hospital
  • Dincer Aydin Dr. Lutfi Kirdar Kartal Education and Training Hospital
  • Nur Sener Dr. Lutfi Kirdar Kartal Education and Training Hospital
  • Mehmet Aliustaoglu Dr. Lutfi Kirdar Kartal Education and Training Hospital
  • Mahmut Gumus Bezmialem University Faculty of Medicine

Abstract

Aim: Lung cancer  is one of the major causes of cancer-related deaths in both sexes and increasing worldwide. In many studies this increase in incidence and mortality was related to the sex, tumor type and clinical characteristics of the patients. The aim of this study was to evaluate the differences in clinical features and the prognostic factors in our female patients with NSCLC.

Methods: We retrospectively analyzed the records of  our 893 patients with non-small cell lung cancer (NSCLC) from 2005 to 2012.  Of these, 773 were male (86.5%) and 120 were female (13.5%) patients. The data included demographic information, histologic classification, clinical staging, presenting symptoms and treatment modalities. Survival was estimated by using Kaplan–Meier method and prognostic factors were evaluated with log-rank and Cox regression tests.

Results: The median age of the female patients was 60.6. The percent of the male and female patients that had a smoking history was 89.6% and 44.9%, respectively. Most common tumor type in female patients was adenocarcinoma (32.7%) and in male patients was squamos cell carcinoma (34.0%). The median survival time for female patients was 13.7 months and for the male patients it was 10.9 months (p>0.05). In univariate analysis, age, weight loss, combination therapy and PS correlated with a better OS for  female patients. In multivariate analysis, only good PS showed consistency with survival for women.

Conclusion: NSCLC in women is different in women as compared with men. Women are more likely to develop adenocarcinoma of the lung and have more favorable prognosis. A more through understanding of the NSCLC in women may lead to new treatment and prevention strategies.

Author Biographies

Umut Kefeli, Medeniyet University Goztepe Education and Training Hospital

Medical Oncology Department

Bala Basak Oven Ustaalioglu, Haydarpasa Numune Education and Training Hospital

Medical Oncology Department

Burcak Yılmaz, Haydarpasa Numune Education and Training Hospital

Medical Oncology Department

Dincer Aydin, Dr. Lutfi Kirdar Kartal Education and Training Hospital

Medical Oncology Department

Nur Sener, Dr. Lutfi Kirdar Kartal Education and Training Hospital

Medical Oncology Department

Mehmet Aliustaoglu, Dr. Lutfi Kirdar Kartal Education and Training Hospital

Medical Oncology Department

Mahmut Gumus, Bezmialem University Faculty of Medicine

Medical Oncology Department

References

Govindan R, Page N, Morgensztern D, et al. Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol 2006; 24: 4539–44.

Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.

Thomas L, Doyle LA, Edelman MJ. Lung cancer in women: emerging differences in epidemiology, biology, and therapy. Chest 2005;128: 370-81.

Giovino GA. Epidemiology of tobacco use in the United States. Oncogene 2002; 21: 7326-40.

Patel JD. Lung cancer in women. J Clin Oncol 2005; 23: 3212-8.

Sen E, Kaya A, Erol S, Savas I, Gonullu U. Lung cancer in women: clinical features and factors related to survival. Tuberk Toraks 2008; 56: 266-74.

Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982; 5: 649–55.

Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000; 92: 205–16.

Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer 1981; 47: 207–14.

Ramalingam S, Pawlish K, Gadgeel S. Lung cancer in young patients: analysis of a Surveillance, Epidemiology, and End Results Database. Am J Clin Oncol 1998; 16: 651-57.

Rivera MP, Stover DE. Gender and lung cancer. Clin Chest Med 2004; 25: 391-400.

Lienert T, Serke M, Schönfeld R, Loddenkemper R. Lung cancer in young females. Eur Respir J 2000; 16: 986-90.

Huhti E, Sutinen S, Reinila A, et al. Lung cancer in a defined geographical area: History and histological types. Thorax 1980; 35: 660-7.

Fry WA, Menck HR, Winchester DP. The national cancer data base report on lung cancer. Cancer 1996; 77: 1947-55.

Coggon D, Acheson ED. Trends in lung cancer mortality. Thorax 1983; 38 : 721-3.

Satcher D, Thompson TG, Koplan JP. Women and smoking: a report of the Surgeon General. Nicotine Tob Res 2002; 4: 7-20.

Zang EA, Wynder EL. Differences in lung cancer risk between men and women: examination of the evidence. J Natl Cancer Inst 1996; 88 :183–92.

Henschke CI, Miettinen OS. Women’s susceptibility to tobacco carcinogens. Lung Cancer 2004; 43: 1–5.

Bain C, Feskanich D, Speizer F, et al. Lung cancer rates in men and women with comparable histories of smoking. J Natl Cancer Inst 2004; 96: 826–34.

Montesinos J, Bare M, Dalmau E, et al. The changing pattern of non-small cell lung cancer between the 90 and 2000 decades. Open Respir Med J 2011; 5: 24-30.

National Cancer Institute 2009. Bethesda M. SEER Cancer Statistics Review, 1975-2006. Online source. Avalaible at http://seer.cancer.gov/csr/1975_2006/.

Devesa SS, Bray F, Vizcaino AP, Parkin DM. International lung cancer trends by histologic type: male: female differences diminishing and adenocarcinoma rates rising. Int J Cancer 2005; 117: 294–9.

Hatcher J, Dover DC. Trends in histopathology of lung cancer in Alberta. Can J Public Health 2003; 94: 292–6.

Thun MJ, Lally CA, Flannery JT, et al. Cigarette smoking and changes in the histopathology of lung cancer. J Natl Cancer Inst 1997; 89: 1580-6.

Ferguson MK, Skosey C, Hoffman PC, et al . Sex-associated differences in presentation and survival in patients with lung cancer. J Clin Oncol 1990; 8: 1402-7.

Radzikowska E, Glaz P, Roszkowski K. Lung cancer in women: age, smoking, histology, performance status, stage, initial treatment and survival: population-based study of 20,561 cases. Ann Oncol 2002; 13: 1087–93.

Albain KS, Rusch VW, Crowley JJ. Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA (N2) and IIIB non-small cell lung cancer: mature results of Southwest Oncology Group phase II study 8805. J Clin Oncol 1995; 13: 1880-92.

Albain KS, Crowley JJ, LeBlanc M. Survival determinants in extensive-stage non-small cell lung cancer: the Southwest Oncology Group experience. Am J Clin Oncol 1991; 9: 1618-26.

Paesmans M, Sculier JP, Libert G. Prognostic factors for survival in advanced non-small cell lung cancer: univariate and multivariate analyses including recursive partitioning and amalgamation algorithms in 1,052 patients. J Clin Oncol 1995; 13: 1221-30.

Published

24.07.2014

Issue

Section

Original Research