Study highlights female survival advantage after pulmonary resection for lung cancer

Women who underwent pulmonary resections for lung cancer had a significantly better prognosis compared with men, researchers reported in Chest.

“There are known differences in cancer incidence and survival between women and men and the reasons for this are not fully understood,” Erik Sachs, MD, doctoral student at the Institution for Molecular Medicine and Surgery and resident in cardiothoracic surgery at Karolinska University Hospital, Stockholm, and colleagues wrote.

Sachs and colleagues conducted a nationwide population-based observational cohort study that included 6,356 patients from the Swedish national quality register for general thoracic surgery to investigate survival in women compared with men after pulmonary resections for lung cancer. Researchers performed individual-level record linkage to other national health-data registers to obtain information on comorbidities, socioeconomic status and vital status for each individual following pulmonary resections for lung cancer.

The primary outcome was time to death from any cause. Risk for death was lower among women compared with men (HR = 0.73; 95% CI, 0.67-0.79; P < .001). The absolute survival difference among both men and women in the cohort was 3% at 1 year, 10% at 5 years and 12% at 10 years. The restricted mean survival time difference at 10 years for men and women was 0.84 (95% CI, 0.61-1.07) years.

The survival advantage in women who underwent pulmonary resections for lung cancer was consistent regardless of age, common comorbidities, socioeconomic status, lifestyle factors, physical performance, type and extent of surgery, tumor characteristics and stage of cancer, according to the researchers.

“Future studies, prospectively exploring possible sex-specific differences in lifestyle factors, sociocultural conditions and clinical management of patients with lung cancer, are needed,” the researchers wrote. “Educational efforts to increase awareness among health care personnel of inequalities in health care might help to mitigate disparities in clinical management.”