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25.5 months (22-29) [Figure 4]. At last follow-up, rates than men. There are different clinical characteristics
22.4% of patients were alive and 77.6% were of lung cancer in women compared with men, such as the
deceased. There were 6.1% (43) alive without disease, higher percentage of ADC in non-smokers, the greater
16.5% (115) alive with disease, 3.3% (23) were dead prevalence of EGFR gene mutations in ADCs among
without disease and 74.1% (520) were dead from lung non-smokers, and better prognosis. Our study reports on
cancer. The only signifi cant prognostic factor for OS the variation in lung cancer patterns and trends across
was stage (P = 0.000). Stage was a predictive factor 10 years in a single center registry. [13-16] Special attention
for better survival and remained signifi cant through has been given to gender, histology, stage and survival.
all years. It shows OS by stage [Figure 5]. Histology We found a high incidence of lung cancer in men that
was unrelated to survival by stages, except for Stage maintained across the years. The majority of patients
IV (P = 0.003). Through the years, survival for Stages were diagnosed at an advanced stage and OS remained
I and II decreased, it maintained for Stage III, and
had an increase of 2 months for Stage IV [Figure 6].
As death by other cause is important for OS, we
analyzed causes of death. Only for Stages I (26.8%)
and II (5.8%) there were deaths without disease. For
Stages III and IV, lung cancer was the main cause
of dead for all patients. Gender and histology were
only related to survival for Stage IV. Women with
ADC and neuroendocrine differentiation had better
survival (P = 0.021), while men with squamous
cell carcinoma had better survival (P = 0.044), both
groups in Stage IV. Also, molecular prognostic factors,
in particular, mutated EGFR was related to better
survival for Stage IV (17.3 [10.3-24.3] months vs.
10.4 [9-11] months; P = 0.02) but when we analyzed
females, there was no difference in survival with
women with EGFR-mutated vs. wild type or unknown
ADC (EGFR-mutated [16.7 months] vs. wild type or Figure 4: Overall survival for all the series
unknown [14.8 months, P = 0.54]).
Longer survival for Stage IV

Median OS for Stage IV patients was nearly 12 months
and there were 100 patients with median OS of
12 months or more in this stage (24.6%). Median OS for
those with < 12 months was only 5 months (4.6-5.3). For
those surviving more than 1-year, OS was 26.5 months
(23-30 range) (P = 0.0000). Prognostic factors related to
longer survival with Stage IV were: female (P = 0.000),
histology (ADC and neuroendocrine), and EGFR mutation
for men only. Longer survival was statistically signifi cant,
related to the year of diagnosis (2011 and 2012,
P = 0.006).
Discussion Figure 5: Overall survival by stages

After the analysis of our 10 years database, we have
found that lung cancer in our region remains a disease
of smoker men. The predominant cause of lung cancer in
men is active cigarette smoking. From our date, we cannot
check the hypothesis that women are more susceptible
than men to smoking-induced lung cancer. What we
have found is that young women are smokers and elderly
are non-smoker lung cancer patients. However, aspects
of lung cancer in men and women continue to indicate
potential male and female differences in the etiology of
lung cancer, which based on several observations. Among
non-smokers, women have higher lung cancer incidence Figure 6: Evolution of median survival for stages across the years

204 Journal of Cancer Metastasis and Treatment ¦ Volume 1 ¦ Issue 3 ¦ October 15, 2015 ¦