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Abstract
Background:
The incidence of adenocarcinoma of the lung has been increasing worldwide, and it has been generally been accepted to be relatively unrelated to smoking with a female preponderance. The aim of this study was to examine the gender-related pathological and survival differences in patients with an adenocarcinoma of the lung.
Material and Method:
A retrospective review of the clinical information of patients diagnosed with an adenocarcinoma of the lung at Kosin Medical Center from January 1999 to September 2005 was performed. The patient's demographics (age, gender), smoking history, stage, serum tumor marker, pathology classification, EGFR mutation, K-ras mutation, treatment methods, and survival time were analyzed.
Result:
Of the 438 patients, 179 (40.9%) were female. The median age at the diagnosis was 58 years for females and 59 years for males. However, 25.8% of women and only 17.7% of men were under 50 years of age (p=0.02). The distribution of the disease stage was similar in both men and women. The bronchioloalveolar carcinoma component was diagnosed more often in women (11.2%) than in men (5.0%). The overall survival rate was higher in women than in men (p=0.01), and women had a superior therapeutic response to a combined treatment of surgery and chemotherapy.
Conclusion:
This study showed significant genders differences in terms of the smoking history, bronchioloalveolar carcinoma component, overall survival, and survival after combined treatment of surgery and chemotherapy. Therefore, gender differences should be considered when diagnosing and treating adenocarcinomas of the lung.
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Figure 1.
Kaplan-Meier curve of overall survival of patients according to the treatment modality between the gender
Figure 2.
Kaplan-Meier curve of the survival between male and female with combined therapy of surgery and chemotherapy
Table 1.
Baseline Characteristics
| Patient Characteristics | Female (n=179) | Male (n=259) | p value |
|---|---|---|---|
| Gender(%) | 40.9 | 59.1 | 0.7 |
| Mean age(years) | 58(30~85) | 59(32~81) | 0.2 |
| Smoking(%) | 18 | 86 | 0.000 |
| Median survival time(days) | 823 | 639 | 0.01 |
Table 2.
The prevalence of adenocarcinoma according to the age
| age | Female | Male | p value | ||
|---|---|---|---|---|---|
| Number | Frequency(%) | Number | Frequency(%) | ||
| ≤ 30 | 1 | 0.6 | 0 | 0 | |
| 31-40 | 10 | 6.2 | 18 | 6.9 | |
| 41-50 | 35 | 25.8 | 28 | 17.7 | 0.02★ |
| 51-60 | 60 | 59.3 | 88 | 51.7 | |
| 61-70 | 47 | 85.6 | 93 | 87.6 | |
| ≥ 71 | 26 | 100 | 32 | 100 | |
| Total | 179 | 259 | |||
Table 3.
Mean values and standard deviation of laboratory results of patients
| Female | Male | p value | |
|---|---|---|---|
| WBC★(109/L) | 8.1±3.7 | 9.0±4.1 | 0.264 |
| Hb†(g/dl) | 11.9±1.3 | 12.7±1.6 | 0.03 |
| PLT‡(109/L) | 306±92 | 288±110 | 0.054 |
| ALP§(U/L) | 178.6±71.4 | 197.6±127.2 | 0.113 |
| LDH∏(U/L) | 342.1±178.8 | 360.4±141.0 | 0.766 |
| CEA¶(ng/ml) | 222.3±858.6 | 168.8±530.7 | 0.084 |
| NSE★★(ng/ml) | 13.3±17.4 | 12.8±10.2 | 0.692 |
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