Exploring sex difference in the risk factors and prognosis of inoperable lung cancer

Q3 Medicine

Cancer treatment and research communications Pub Date : 2024-01-01 DOI:10.1016/j.ctarc.2024.100848

Muhammad Rafiqul Islam , Syeda Masuma Siddiqua , Golam Rabbani , Salman Bashar Al Ayub , Rashedul Islam , Beauty Saha , Nazrina Khatun , Mohammad Hasan Shahriar , Mohammad Rocky Khan Chowdhury , Sheikh M Alif , Md Nazmul Karim

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引用次数: 0

Abstract

Background

Lung cancer remains a leading cause of cancer-related deaths globally, with increasing incidence among females. Sex differences in lung cancer risk and outcomes are influenced by various factors, including biological characteristics. In Bangladesh, where lung cancer mortality rates are high, patients often present at advanced stages. However, real-time data on sex-specific survival outcomes for inoperable lung cancer in Bangladesh is lacking.

Methods

This retrospective study analyzed patients with inoperable lung cancer at the National Institute of Cancer Research and Hospital in Dhaka, Bangladesh, from 2018 to 2019. Patient demographics and clinical parameters were assessed, with survival tracked until June 2020. Statistical analyses included descriptive statistics, Chi-square tests, t-tests, Kaplan-Meier curves, and multivariable Cox regression models.

Results

Females were diagnosed at a younger age (55.3 ± 12.7 vs 60.5 ± 10.2 years, p < 0.001) and had higher comorbidity rates (36.2 %, p = 0.004). Males had higher smoking rates, while females used more smokeless tobacco. Adenocarcinoma was more prevalent in females (47.2 %) and squamous cell carcinoma in males (42.7 %). After adjusting for various factors, females showed a significant survival advantage (median 16 vs 12 months), particularly in adenocarcinoma (HR: 0.64, 95 %CI:0.46–0.90, p = 0.01) and squamous cell carcinoma (HR: 0.52, 95 %CI:0.32–0.85, p = 0.009). Females also demonstrated better survival when receiving supportive care, chemotherapy, or radiotherapy alone but not in combined therapy. Older males (>70), illiterate, smokers, and those with comorbidities had a poor prognosis compared to females.

Conclusion

This study reveals significant sex-based differences in inoperable lung cancer patients in Bangladesh. Despite earlier diagnosis and higher comorbidities, females demonstrated better survival rates, particularly in adenocarcinoma and squamous cell carcinoma. These findings highlight the need for sex-specific approaches in lung cancer management to improve patient outcomes.

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探讨无法手术的肺癌风险因素和预后的性别差异

背景肺癌仍然是全球癌症相关死亡的主要原因，女性的发病率不断上升。肺癌风险和结果的性别差异受多种因素影响，包括生物特征。在孟加拉，肺癌死亡率很高，患者通常处于晚期。然而，孟加拉国缺乏不可手术肺癌性别特异性生存结果的实时数据。方法这项回顾性研究分析了2018年至2019年孟加拉国达卡国家癌症研究所和医院的不可手术肺癌患者。对患者的人口统计学和临床参数进行了评估，并对2020年6月之前的生存情况进行了追踪。统计分析包括描述性统计、Chi-square 检验、t 检验、Kaplan-Meier 曲线和多变量 Cox 回归模型。结果女性确诊年龄较小（55.3 ± 12.7 岁 vs 60.5 ± 10.2 岁，p < 0.001），合并症发生率较高（36.2%，p = 0.004）。男性吸烟率较高，而女性使用无烟烟草较多。女性腺癌发病率更高（47.2%），男性鳞状细胞癌发病率更高（42.7%）。在对各种因素进行调整后，女性的生存期有明显优势（中位 16 个月对 12 个月），尤其是腺癌（HR：0.64，95 %CI：0.46-0.90，p = 0.01）和鳞癌（HR：0.52，95 %CI：0.32-0.85，p = 0.009）。女性在单独接受支持治疗、化疗或放疗时，生存率也较高，但在接受联合治疗时则不然。与女性相比，老年男性（70 岁）、文盲、吸烟者和合并症患者的预后较差。尽管女性肺癌患者确诊较早且合并症较多，但她们的生存率更高，尤其是腺癌和鳞癌患者。这些发现凸显了在肺癌治疗中采取有性别针对性的方法来改善患者预后的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer treatment and research communications Medicine-Oncology

CiteScore

4.30

自引率

0.00%

发文量

148

审稿时长

56 days

期刊介绍： Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.