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Lung Cancer in Women^*

Sex-Associated Differences in Survival of Patients Undergoing Resection for Lung Cancer

^* From the Department of Thoracic Surgery, Hyogo Medical Center for Adults, Akashi City, Hyogo, Japan.

Correspondence to: Noriaki Tsubota, MD, Department of Thoracic Surgery, Hyogo Medical Center for Adults, Kitaohji-cho 13-70, Akashi City 673, Hyogo, Japan; e-mail: n-tsubo{at}sanynet.ne.jp

Study objectives: The aim of this study was to analyze various characteristics and survival in female patients treated surgically for lung cancer.

Design: Retrospective clinical study.

Patients: From 1,242 consecutive cases of primary non-small cell lung cancer treated with pulmonary resection between June 1984 and December 1998, 337 female patients (27.1%) were chosen.

Results: Female patients had the following characteristics: a significantly younger age at onset (62.5 ± 0.56 years vs 64.1 ± 0.31 years for men), a higher frequency of adenocarcinoma (86.0% vs 48.3% for men), and smaller tumors (32.7 mm vs 38.3 mm in diameter for men). Peripheral tumors were significantly more common in women than men (71.8% vs 50.6%, respectively). Among 686 patients with a history of smoking, the women smoked significantly less often (12.8% vs 91.4% for men). Complete resection was achieved significantly less often in women (79.6% vs 85.2% for men); however, women having complete resection survived significantly longer than their male counterparts. Women with a postoperative negative carcinoembryonic antigen (CEA) had a significantly better prognosis than men; however, women with a postoperative positive CEA did not. Women 60 years old survived significantly longer than their male counterparts, while women < 60 years old did not.

Conclusions: Once the tumor was resected completely, women survived longer, partly due to the influence of life expectancy. However, the incidence of malignant effusion was higher and the rate of complete resection was lower in women.

Key Words: Brinkman index • carcinoembryonic antigen • female • lung cancer • pleural lavage • surgery • survival

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