GENDER INFLUENCE ON WEIGHT-LOSS PATTERN AND SURVIVAL OF NONSMALL CELLLUNG-CARCINOMA PATIENTS

BACKGROUND. Gender has recently emerged as a discriminating factor in nonsmall lung carcinoma (NSCLC) patient outcome. Since the potential f or interaction among established prognostic factors and gender in this common disease has not been explored, the authors evaluated the role of gender and weight-loss pattern in predicting clinical outcome in a balanced population of men and women presenting with NSCLC. METHODS. F rom a tumor registry population of 368 NSCLC patients, a gender-balanc ed sample of 152 cases was randomly selected for review, using prospec tive inclusion criteria. Study parameters were age, race, tobacco and alcohol history, gender, weight-loss pattern, histology, TNM stage, Ea stern Cooperative Oncology Group performance status, and therapy. Infl uences of study variables on Kaplan-Meier estimates of survival were s ubsequently determined using univariate and multivariate analyses. RES ULTS. Overall median survival after diagnosis was significantly shorte r for men with NSCLC than for women with the disease (40 vs. 78 weeks, P = 0.001). Men lost significantly more weight over their disease cou rse than women (12.2 vs. 5.4 pounds, P = 0.006) and experienced an eig htfold faster rate of initial weight loss (0.25 vs. 0.03 pounds per we ek, P = 0.001). In multivariate analysis, the strongest independent pr edictors of NSCLC patient survival were stage of disease, initial weig ht-loss rate, and gender (all P < 0.0001). CONCLUSIONS. These results suggest that weight loss may play a role in mediating gender-related d ifferences in NSCLC patient survival and provide an impetus for furthe r studies of gender influence on cancer outcome. (C) 1996 American Can cer Society.