引言性别差异可能影响肺神经内分泌肿瘤(L-NET)的发病,在其他癌症中出现的进展和结果。本研究旨在分析L-NET的性别差异,以确定潜在的预后因素。改善患者随访和治疗策略。方法经组织学证实的L-NEN诊断的患者(pt)转诊至内分泌科的ENETSCoE,费德里科二世那不勒斯大学,从2013年到2023年进行了回顾性评估.结果在L-NEN的48pt中,38例(79,2%)散发性L-NET纳入:22例典型(57,9%)和16例非典型(42,1%)类癌,22(57,9%)女性和16(42,1%)男性,诊断时的平均年龄57,3岁(范围16-84)。中位随访时间为70,5个月(范围12-305)。关于吸烟习惯,没有统计学差异,体重指数(BMI),原发部位(左/右和中央/外周)和组织学特征,队列之间。诊断时的转移发现于20pt(52,3%),10名女性(10%),10名男性(10%)(p:0,20)。在14(36,8%)pt中观察到进行性疾病(PD),男性患PD的频率为9/14(64,3%),女性5(35,7%),p:0.05。男性似乎更频繁地显示骨转移,但没有达到统计学差异,7男性/10(70%),p:0.06。在9例死亡(23,7%)中,7人(77,8%)为男性,7人因PD死亡,p<0,03。在无进展生存期(p:0.04)和总生存期(p:0.001)方面,男性的预后比女性差。还比较了诊断时pt转移的亚组(p:0,02和p:0,02)。结论本研究显示L-NET患者的男性预后比女性差。尽管临床特征相似,肿瘤类型,阶段和治疗,关于PFS,OS和转移扩散。这些发现可能暗示了对男性的更密切的随访,对结果有潜在的积极影响。
BACKGROUND: Gender difference may affect lung neuroendocrine tumor (L-NET) onset, progression, and outcomes as emerged in other cancers. This study aimed to analyze gender difference in L-NET to identify potential prognostic factors, to improve patient follow-up and therapeutic strategies.
METHODS: Patients with histologically confirmed L-NEN diagnosis referred to the ENETS CoE of the Endocrinology Unit, Federico II University of Naples, from 2013 to 2023, were retrospectively evaluated.
RESULTS: Among 48 patients with L-NEN, 38 (79.2%) with sporadic L-NET were enrolled: 22 typical (57.9%) and 16 atypical (42.1%) carcinoids, 22 (57.9%) female and 16 (42.1%) male, mean age at diagnosis 57.3 years (range 16-84). Median follow-up was 70.5 months (range 12-305). No statistical difference resulted regarding smoking habit, BMI, primary site (left/right and central/peripheral), and histological characteristics, between cohorts. Metastasis at diagnosis was found in 20 patients (52.3%), 10 female (10%) and 10 male (10%) (p: 0.20). Progressive disease (PD) was observed in 14 (36.8%) patients, and male sex developed PD more frequently 9/14 (64.3%) than female 5 (35.7%), p: 0.05. Male sex seemed to show more frequently bone metastasis without reaching statistical difference, 7 male/10 (70%), p: 0.06. Among 9 deaths (23.7%), 7 (77.8%) were men and 7 died for PD, p < 0.03. Male had a poorer prognosis than female regarding progression-free survival (PFS) (p: 0.04) and overall survival (p: 0.001), also when sub-groups of patient metastatic at diagnosis were compared (p: 0.02 and p: 0.02).
CONCLUSIONS: This study showed a worse prognosis in male than female with L-NET, despite similar clinical features, tumor type, stage, and treatment, with regard to PFS, OS, and metastatic spread. These findings may suggest a closer follow-up in men, with potential positive impact on outcomes.