Miguel Barquín1, Virginia Calvo1, Francisco García-García2, Beatriz Nuñez1, Estela Sánchez-Herrero1, Roberto Serna-Blasco1, Milda Auglytė1, Enric Carcereny3, Delvys Rodriguez-Abreu4, Rafael López Castro5, María Guirado6, Carlos Camps7, Joaquín Bosch-Barrera8, Bartomeu Massuti9, Ana Laura Ortega10, Edel Del Barco11, José Luis Gonzalez-Larriba12, David Aguiar13, Rosario García-Campelo14, Manuel Dómine15, Sara Agraso16, Mª Angeles Sala17, Juana Oramas18, Reyes Bernabé19, Remei Blanco20, Consuelo Parejo21, Alberto Cruz1, Ernestina Menasalvas22, Ana Royuela23, Atocha Romero24, Mariano Provencio25. 1. Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. 2. Bioinformatics & Biostatistics Unit, Príncipe Felipe Research Center, Valencia, Spain. 3. Institut Català d'Oncologia Badalona-Hospital Germans Trias i Pujol, B-ARGO GROUP Badalona Applied Research Group in Oncology, Badalona, Spain. 4. Hospital Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain. 5. Hospital Clínico Universitario de Valladolid, Valladolid, Spain. 6. Hospital General Universitario de Elche, Elche, Spain. 7. Hospital General Universitario de Valencia, Valencia, Spain. 8. Catalan Institute of Oncology, Girona, Spain. 9. Hospital Universitario General de Alicante, Alicante, Spain. 10. Complejo Hospitalario de Jaen, Jaen, Spain. 11. Hospital Universitario de Salamanca, Salamanca, Spain. 12. Hospital Clínico San Carlos, Madrid, Spain. 13. Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas, Spain. 14. Hospital Universitario de la Coruña, La Coruña, Spain. 15. Hospital Fundación Jiménez Díaz, Madrid, Spain. 16. Complejo Hospitalario Universitario de Vigo, Vigo, Spain. 17. Hospital de Basurto, Bilbao, Spain. 18. Hospital Universitario de Canarias, Tenerife, Spain. 19. Hospital Universitario Virgen del Rocio, Seville, Spain. 20. Hospital de Terrassa, Barcelona, Spain. 21. TIC Unit, Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. 22. Center for Biomedical Technology, Universidad Politécnica de Madrid, Madrid 28000, Spain. 23. Biostatistics Unit, CIBERESP, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. 24. Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. Electronic address: atocha10@hotmail.com. 25. Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. Electronic address: mariano.provencio@salud.madrid.org.
Abstract
BACKGROUND: Biological differences between the sexes have a major impact on disease and treatment outcome. In this paper, we evaluate the prognostic value of sex in stage IV non-small-cell lung cancer (NSCLC) in the context of routine clinical data, and compare this information with other external datasets. METHODS: Clinical data from stage IV NSCLC patients from Hospital Puerta de Hierro (HPH) were retrieved from electronic health records using big data analytics (N = 397). In addition, data from the Spanish Lung Cancer Group (GECP) Tumor Registry (N = 1382) and from a published study available from the cBioPortal (MSK) (N = 601) were analyzed. Survival curves were estimated using the Kaplan-Meier method. A Cox proportional hazards regression model was used to assess the prognostic value of sex. A meta-analysis to compare the outcome for males and females in terms of overall survival (OS) and progression free survival (PFS) was performed. RESULTS: The median OS time was 12 months for males and 19 months for females (overall HR = 0.77; 95% CI: 0.68-0.87; P < 0.001). Similarly, females with stage IV NSCLC harboring an EGFR-sensitizing mutation lived significantly longer than males (median OS: males, 19 months; females, 32 months) with a lower risk of death compared with males (overall HR = 0.75; 95% CI: 0.67-0.84). In addition, female patients benefited more from EGFR inhibitors in terms of PFS and OS (overall HR = 0.45; 95% CI: 0.32-0.64, and HR = 0.62; 95% CI: 0.48-0.80, respectively). Median PFS was 21 months in females and 12 months in males (P < 0.001). CONCLUSIONS: Using routine clinical data we confirmed the previous finding that among stage IV NSCLC patients, females had a significantly better prognosis than males. The effect size of the sex was notable, highlighting the fact that survival rates are usually estimated and patients are generally managed without considering the sexes separately, which may lead to suboptimal results.
BACKGROUND: Biological differences between the sexes have a major impact on disease and treatment outcome. In this paper, we evaluate the prognostic value of sex in stage IV non-small-cell lung cancer (NSCLC) in the context of routine clinical data, and compare this information with other external datasets. METHODS: Clinical data from stage IV NSCLCpatients from Hospital Puerta de Hierro (HPH) were retrieved from electronic health records using big data analytics (N = 397). In addition, data from the Spanish Lung Cancer Group (GECP) Tumor Registry (N = 1382) and from a published study available from the cBioPortal (MSK) (N = 601) were analyzed. Survival curves were estimated using the Kaplan-Meier method. A Cox proportional hazards regression model was used to assess the prognostic value of sex. A meta-analysis to compare the outcome for males and females in terms of overall survival (OS) and progression free survival (PFS) was performed. RESULTS: The median OS time was 12 months for males and 19 months for females (overall HR = 0.77; 95% CI: 0.68-0.87; P < 0.001). Similarly, females with stage IV NSCLC harboring an EGFR-sensitizing mutation lived significantly longer than males (median OS: males, 19 months; females, 32 months) with a lower risk of death compared with males (overall HR = 0.75; 95% CI: 0.67-0.84). In addition, female patients benefited more from EGFR inhibitors in terms of PFS and OS (overall HR = 0.45; 95% CI: 0.32-0.64, and HR = 0.62; 95% CI: 0.48-0.80, respectively). Median PFS was 21 months in females and 12 months in males (P < 0.001). CONCLUSIONS: Using routine clinical data we confirmed the previous finding that among stage IV NSCLCpatients, females had a significantly better prognosis than males. The effect size of the sex was notable, highlighting the fact that survival rates are usually estimated and patients are generally managed without considering the sexes separately, which may lead to suboptimal results.
Authors: Mariano Provencio; Manuel Cobo; Delvys Rodriguez-Abreu; Virginia Calvo; Enric Carcereny; Alexandra Cantero; Reyes Bernabé; Gretel Benitez; Rafael López Castro; Bartomeu Massutí; Edel Del Barco; Rosario García Campelo; Maria Guirado; Carlos Camps; Ana Laura Ortega; Jose Luis González Larriba; Alfredo Sánchez; Joaquín Casal; M Angeles Sala; Oscar Juan-Vidal; Joaquim Bosch-Barrera; Juana Oramas; Manuel Dómine; Jose Manuel Trigo; Remei Blanco; Julia Calzas; Idoia Morilla; Airam Padilla; Joao Pimentao; Pedro A Sousa; Maria Torrente Journal: BMC Cancer Date: 2022-07-05 Impact factor: 4.638
Authors: Irene Pérez-Díez; Marta R Hidalgo; Pablo Malmierca-Merlo; Zoraida Andreu; Sergio Romera-Giner; Rosa Farràs; María de la Iglesia-Vayá; Mariano Provencio; Atocha Romero; Francisco García-García Journal: Cancers (Basel) Date: 2021-01-05 Impact factor: 6.639
Authors: Alberto Ruano-Ravina; Mariano Provencio; Virginia Calvo de Juan; Enric Carcereny; Anna Estival; Delvys Rodríguez-Abreu; Gretel Benítez; Rafael López-Castro; Marta Belver; María Guirado-Risueño; Carlos Guirao-Rubio; Ana Blasco; Bartomeu Massutí; Ana Laura Ortega; Manuel Cobo; Joaquín Mosquera-Martínez; Carlos Aguado de la Rosa; Joaquim Bosch-Barrera; Amparo Sánchez-Gastaldo; Edel Del Barco Morillo; Óscar Juan; Manuel Dómine; José Manuel Trigo; Diego Pereiro Corbacho; Juana Oramas Journal: Transl Lung Cancer Res Date: 2021-10
Authors: Da Som Jeon; Jin Woo Kim; Seul Gi Kim; Hyeong Ryul Kim; Si Yeol Song; Jae Cheol Lee; Wonjun Ji; Chang-Min Choi; Ho Cheol Kim Journal: Thorac Cancer Date: 2022-07-29 Impact factor: 3.223