The prognostic impact of sex on surgically resected non-small cell lung cancer depends on clinicopathologic characteristics

Am J Clin Pathol. 2011 Apr;135(4):611-8. doi: 10.1309/AJCPQF24NYWNMVMG.

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.

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / metabolism
  • Adenocarcinoma / mortality
  • Adult
  • Aged
  • Aged, 80 and over
  • Austria / epidemiology
  • Biomarkers, Tumor / metabolism
  • Carcinoma, Adenosquamous / diagnosis
  • Carcinoma, Adenosquamous / metabolism
  • Carcinoma, Adenosquamous / mortality
  • Carcinoma, Large Cell / diagnosis
  • Carcinoma, Large Cell / metabolism
  • Carcinoma, Large Cell / mortality
  • Carcinoma, Mucoepidermoid / diagnosis
  • Carcinoma, Mucoepidermoid / metabolism
  • Carcinoma, Mucoepidermoid / mortality
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / metabolism
  • Carcinoma, Squamous Cell / mortality
  • Carcinosarcoma / diagnosis
  • Carcinosarcoma / metabolism
  • Carcinosarcoma / mortality
  • Female
  • Humans
  • Ki-67 Antigen / metabolism
  • Lung / metabolism
  • Lung / pathology
  • Lung / surgery
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Sex Factors
  • Survival Rate
  • Tissue Array Analysis
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Ki-67 Antigen