Mr. Palomares et al., GENDER INFLUENCE ON WEIGHT-LOSS PATTERN AND SURVIVAL OF NONSMALL CELLLUNG-CARCINOMA PATIENTS, Cancer, 78(10), 1996, pp. 2119-2126
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.