Genderspezifische Unterschiede des Lungenkarzinoms

Zusammenfassung

Immer mehr Frauen erkranken an Lungenkrebs. Im Vergleich zu erkrankten Männern sind sie jünger und häufiger Nieraucher, auch finden sich bei ihnen häufiger Adenokarzinome. Ihre Prognose scheint nach chirurgischer Therapie im frühen Tumorstadium besser als bei Männern zu sein. Da bei Frauen häufiger für das Tumorwachstum maßgebliche Treibergene gefunden werden, die Angriffspunkte für zielgerichtete Medikamente sein können, ist ein größerer therapeutischer Erfolg durch zielgerichtete stratifizierte medikamentöse Behandlungen bei ihnen möglich. Ziel dieser Übersicht ist die Darstellung einiger genderspezifischer Unterschiede bei Diagnostik und Therapie von Lungenkrebs.

Abstract

More and more women suffer from lung cancer. In comparison to the male patients they are younger and more likely never-smokers. Adenocarcinomas are more frequently in women than in men. Their long-time survival post curative resection in early stage non-small-cell lung cancer is better than in men. Women show frequently more molecular changes: more molecular targets are found. Therefore they might benefit more from target-oriented stratified medical treatments. This overview comments on the gender-specific differences in diagnostics, treatment and outcome of lung cancer.

Schlüsselwörter

Überleben - Thoraxchirurgie - Prognosefaktor - Lungenkarzinom - Gender

Key words

survival - thoracic surgery - prognostic factors - lung cancer - gender

• Literatur

• 1 Statistisches Bundesamt. Todesursachenstatistik. Wiesbaden: 2011
• 2 Parkin DM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin 1999; 49: 33-64
• 3 Malvezzi M, Bertuccio P, Levi F et al. European cancer mortality predictions for the year. Ann Oncol 2013; 24: 792-800
• 4 Giovino GA, Mirza S, Samet JM et al. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representatives cross-sectional household surveys. Lancet 2012; 380: 668-679
• 5 La Veccia C, Bosetti C, Lucchini F. Cancer mortality in Europe, 2000–2004, and an overview of trends since 1975. Ann Oncol 2010; 21: 1323-1360
• 6 Kligerman S, White C. Epidemiology of lung cancer in women: risk factors, survival, and screening. Am J Roentgenol 2011; 198: 287-295
• 7 Goeckenjan G, Sitter H, Thomas M et al. Prävention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms – Interdisziplinäre S3-Leitlinien der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin und der Deutschen Krebsgesellschaft – Kurzfassung. Pneumologie 2011; 65: e51-e75
• 8 Moore R, Doherty D, Chamberlain R et al. Sex differences in survival in non-small-cell lung cancer patients 1974–1998. Acta Oncol 2004; 25: 57-64
• 9 Radzikowska E, Glaz P, Roszkowski K. Lung cancer in women: age, smoking, history, performance status, stage, initial treatment and survival. Population-based study of 20561 cases. Ann Oncol 2002; 13: 1087-1093
• 10 Cerfolio RJ, Bryant AS, Scott E. Women with pathologic stage I, II, and III non-small cell lung cancer have better survival than men. Chest 2006; 130: 1796-1802
• 11 Nakamura H, Ando K, Shinmyo T et al. Female gender is an independent prognostic factor in non-small-cell lung cancer: a meta-analysis. Ann Thorac Cardiovasc Surg 2011; 17: 469-480
• 12 Nimako K, Gunapala R, Popat S et al. Patient factors, health care factors and survival from lung cancer according to ethnic group in the south of London, UK. Eur J Cancer Care (Engl) 2013; 22: 79-87
• 13 Alexiou C, Onyeaka CV, Beggs D et al. Do women live longer following lung resection for carcinoma?. Eur J Cardiothorac Surg 2002; 21: 319-325
• 14 Minami H, Yoshimura M, Miyamoto Y et al. Lung cancer in women: sex-associated differences in survival of patients undergoing resection for lung cancer. Chest 2000; 118: 1603-1609
• 15 Warwick R, Shackcloth M, Midiratta N. Female sex and long-term survival post curative resection for non-small-cell lung cancer. Eur J Cardiothorac Surg 2013; 44: 624-630
• 16 Traibi A, Grigoroiu M, Boulitrop C et al. Predictive factors for complications of anatomic pulmonary segmentectomies. Interact Cardiovasc Thorac Surg 2013; 17: 838-844
• 17 Grundmann RT, Meyer F. Geschlechterspezifische Einflüsse auf die Ergebnisse der Gefäßchirurgie. Zentralbl Chir 2013; 138: 210-218
• 18 Albain KS, Unger J, Gotay CC et al. Toxicity and survival by sex in patients with advanced non-small cell lung carcinoma on modern Southwest Oncology Group trials. Proc Am Soc Clin Oncol 2007; 25: 396s
• 19 Wakelee HA, Wang W, Schiller JH et al. Survival differences by sex for patients with advanced non-small cell lung cancer on Eastern Cooperative Oncology Group trial 1594. J Thorac Oncol 2006; 1: 441-446
• 20 McGovern SL, Liao Z, Bucci K et al. Is sex associated with the outcome of patients treated with radiation for non small cell lung cancer?. Cancer 2009; 115 (Suppl. 14) S3233-S3242
• 21 Siddiqui F, Bae K, Langer CJ. The influence of gender, race and marital status on survival in lung cancer patients, analysis of Radiation Therapy Oncology Group trials. J Thorac Oncol 2010; 5: 631-639
• 22 Risch HA, Howe GR, Jain M et al. Are female smokers at higher risk for lung cancer than male smokers?. Am J Epidemiol 1993; 138: 281-293
• 23 Jha P, Ramasundarahettige C, Landsman V et al. 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med 2013; 368: 341-350
• 24 Freedman ND, Leitzmann MF, Hollenbeck AR. Cigarette smoking and subsequent risk of lung cancer in men and women: analysis of a prospective cohort study. Lancet Oncol 2008; 9: 649-656
• 25 Planchard D, Loriot Y, Goubar A et al. Differential Expression of Biomarkers in men and women. Semin Oncol 2009; 36: 553-567
• 26 Gasperino J. Gender is a risk factor for lung cancer. Med Hypotheses 2011; 76: 328-331
• 27 Ganti AK, Sahmoun AE, Panwalkar AW. Hormone replacement therapy is associated with decreased survival in women with lung cancer. J Clin Oncol 2006; 24: 59-63
• 28 Öberg M, Jaajjola MS, Woodward A et al. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 2011; 377: 139-146
• 29 Lo YL, Hsiao CF, Chang GC et al. Risk factors for primary lung cancer among never smokers by gender in a matched case-control study. Cancer Causes Control 2013; 24: 567-576
• 30 Sun S, Schiller JH, Gazdar AF. Lung cancer in never smokers – a different disease. Nat Rev Cancer 2007; 7: 778-790
• 31 Böker B, Lüders H, Grohé C. Prognoserelevanz von Body-Mass-Index Rash für Patienten mit metastasiertem nichtkleinzelligen Lungenkarzinom und Therapie mit Erlotinib. Pneumologie 2012; 66: 89-95
• 32 Nelson HH, Christiani DC, Mark EJ et al. Implications and prognostic value of K-ras mutation for early-stage lung cancer in women. J Natl Cancer Inst 1999; 91: 2232-2238
• 33 Toyooka S, Tsuda T, Gazdar AF. The TP53 gene, tobacco exposure, and lung cancer. Hum Mutat 2003; 21: 229-239
• 34 Shaw AT, Yeap BY, Mino-Kenudson M. Clinical features and outcome of patients with non-small-cell lung cancer who harbor EML4-ALK. J Clin Oncol 2009; 27: 4247-4253
• 35 Linden W, Vodermaier A, Mackenzie R et al. Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender and age. J Affect Disord 2012; 141: 343-351