Sex-associated differences in survival of patients undergoing resection for lung cancer

Background. The increasing incidence of lung cancer among women prompted us to assess whether sex-associated differences exist in the presentation and survival of patients who undergo major lung resection for lung cancer. Methods. We performed a retrospective review of patients who had major lung resection for lung cancer from January 1980 to June 1998. Results. There were 265 men and 186 women. Women were younger (60.7 +/- 0.8 versus 63.6 +/- 0.6 years; p = 0.005). Adenocarcinoma was more common amon g women (48% versus 40%; p = 0.001). Pathologic stages for men were: I = 43 %, II = 26%, IIIA = 25%, IIIB or IV 6%, and for women: I = 52%, II = 20%, I IIA = 22%, IIIB or IV = 6% (p = 0.146). Median survival was better for wome n (41.8 versus 26.9 months; p = 0.006). This was due both to a difference i n stage at presentation and to a better median survival rate for adenocarci noma compared with squamous cell cancer. The data suggest an association be tween sex and survival, although this failed to reach statistical significa nce. Sex influenced survival with a relative risk for women of 0.67 (95% co nfidence interval 0.35 to 1.29; p = 0.231 adjusted for stage, cell type, ag e, and spirometry). Conclusions. There are sex-associated differences in the presentation and p ossibly in the survival of patients with lung cancer. This finding has poss ible implications regarding the selection of patients for therapy and for t he design of randomized therapeutic trials. (C) 2000 by The Society of Thor acic Surgeons.