Evaluating Clinical Outcomes Across Sex and Ethnicity in Patients With Early-Stage Non-small Cell Lung Cancer (NSCLC).
Publication/Presentation Date
10-1-2025
Abstract
BACKGROUND: Although there are well-studied sex and racial/ethnic disparities within lung cancer patients, they do not examine the interface of these inequities. We aim to utilize a national database to evaluate clinical outcomes and disparities within racial/ethnic groups of female patients with early-stage lung cancer.
METHODS: The 2020 National Cancer Database (NCDB) was queried for patients with clinical stage I non-small cell lung cancer (NSCLC) with known vital status between 2010 and 2019. Patients with carcinoid tumors were excluded. Demographic data, clinicopathologic variables, 30-d, 90-d, 5-y mortality, and 5-y overall survival were analyzed.
RESULTS: A total of 344,223 patients met the inclusion criteria, of which 187,588 were female (54.4%). Within ethnic subgroups, 5-y survival was highest among Asian/Pacific Islander women (API) (77.8%) (P < 0.001). API women had the highest rates of surgical resection (75.7%), with higher rates of nodes examined (73.1%) and nodal upstaging (13.4%) (P < 0.001). Black and White women had the lowest rates of 5-y survival (60%, 58.8%) and surgical resection (59.1%, 62.2%) (P < 0.001). API women had the least comorbidities (CCI = 0, 71.1%; P < 0.001) and highest rates of well-differentiated tumors (28.7%, P < 0.001).
CONCLUSIONS: API women had the highest survival rates, highest rates of surgical resection with nodal sampling, and low-grade tumors. Black and White women had the lowest rates of overall survival and surgical resection. This disparity in guideline-concordant surgery highlights the importance of acknowledging the racial/ethnic heterogeneity among women with early-stage NSCLC and that female lung cancer patients should not be treated as a monolith.
Volume
314
First Page
59
Last Page
70
ISSN
1095-8673
Published In/Presented At
Madeka, I., Ho, A., Rshaidat, H., Alaparthi, S., Whitehorn, G. L., Ishwar, A., Grenda, T. R., Jacob, J., Evans, N. R., 3rd, & Okusanya, O. T. (2025). Evaluating Clinical Outcomes Across Sex and Ethnicity in Patients With Early-Stage Non-small Cell Lung Cancer (NSCLC). The Journal of surgical research, 314, 59–70. https://doi.org/10.1016/j.jss.2025.06.002
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
40716200
Department(s)
Administration and Leadership
Document Type
Article