Sex Is A Strong Prognostic Factor For Overall Survival In Advanced Non Small Cell Lung Cancer Patients And Should Be Considered For Survival Rates Estimations.

e20580 Background: Biological differences between sexes have a major impact on disease and treatment outcome. In this paper, we evaluate the prognostic value of sex in advance NSCLC in the context of real world data. Methods: Clinical data from stage IV non-small cell lung cancer (NSCLC) patients from Hospital Puerta de Hierro (HPH) was retrieved from Electronical records using BigData Analytics (N = 387). In addition, data from Spanish Lung Cancer Group (GECP) Tumor Registry (N = 1382) and from a published study through cBioPortal (MSK) (N = 601) was analyzed. Survival curves were estimated using Kaplan-Meier analysis. Cox proportional hazards regression model was used to assess the prognostic factor of sex. Results: The median overall survival (OS) time was 12 months for men and 19 months for women (P < 0.001). Similarly, women with stage IV NSCLC harbouring an EGFR sensitizing mutation lived longer than men (median overall survival was 19 months for men and 32 months for women). Gender effect was still significant after adjustment by Cox regression for other potential confounding factors. The adjusted hazard ratios for sex were 0.65 (95% CI, 0.51-0.83), 0.84 (95% CI, 0.66-1.1) and 0.76 (95% CI, 0.65-0.88) for HPH, MSK and GECP data sets respectively. Similarly, in EGFR positive population adjusted hazard ratios for sex were 0.53 (95% CI, 0.25-1.1), 0.59 (95% CI, 0.35-0.98) and 0.60 (95% CI, 0.45-0.86) for HPH, MSK and GECP data sets respectively. Conclusions: Using real world data we confirm previous finding that among stage IV NSCLC patients, women live almost twice longer than men. This effect persisted after adjusting for several factors highlighting the fact that survival rates estimations which are usually performed grouping men and women together might not be accurate enough for prognosis assessments