Cancer Res Treat.  2021 Jan;53(1):104-111. 10.4143/crt.2020.894.

Active Treatment Improves Overall Survival in Extremely Older Non–Small Cell Lung Cancer Patients: A Multicenter Retrospective Cohort Study

• Lee SY
• Hong YK
• Ji W
• Lee JC
• Choi CM
• Korean Association for Lung Cancer
• Korea Central Cancer Registry

• KMID: 2510652
• DOI: http://doi.org/10.4143/crt.2020.894

Abstract

Purpose
As the aging of society progresses, the proportion of extremely older lung cancer patients has also increased; However, studies of these patients with non–small cell lung cancer are limited. Therefore, we investigated the initial treatment modalities and survival outcomes for patients aged 80 years or over.
Materials and Methods
We included a multicenter retrospective cohort from the Korean Association for Lung Cancer Registry, which surveys 10% of the newly diagnosed lung cancer patients across 52 hospitals in Korea. We analyzed and compared the 2014–2016 data of the non–small cell lung cancer patients aged ≥ 80 years and those aged < 80 years.
Results
Of the 6,576 patients reviewed, 780 patients were aged ≥ 80 years, and 5,796 patients were aged < 80 years. In the patients aged ≥ 80 years, surgery and radiation therapy resulted in longer patient survival among those with a resectable tumor (stage I–II) than the best supportive care (median survival, not reached [surgery] vs. 32.2 months [radiation therapy] vs. 11.43 months [best supportive care]). The duration of survival in patients with advanced-stage (IV) lung cancers was higher after chemotherapy than after the best supportive care (median survival, 8.63 months vs. 2.5 months). Patients with stage IV adenocarcinoma who received targeted therapy had better survival than those who did not (median survival, 9.0 months vs. 4.3 months).
Conclusion
Even in extremely older patients, active treatments, such as surgery, radiation therapy, and chemotherapy, can result in better survival outcomes than the best supportive care.

Keyword

Carcinoma; Non-small cell lung carcinoma; Aged 80 years or above; Survival analysis

Figure

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  Fig. 1 Overall survival of stage I–II (A) and stage IV (B) non–small cell lung cancer (NSCLC) patients aged 80 years or older stratified by initial treatment modalities. Overall survival of patients with stage IV adenocarcinoma treated with and without a targeted agent (C). (A) In patients aged ≥ 80 years, surgery and radiation therapy resulted in longer patient survival among those with the resectable stage (I–II) than the best supportive care (median survival, not reached [surgery] vs. 32.2 months [radiation] vs. 11.43 months [best supportive care]). (B) Chemotherapy resulted in longer survival of patients with advanced-stage (IV) disease than best supportive care (median survival, 8.63 months vs. 2.5 months). (C) Stage IV adenocarcinoma patients who received targeted therapy had better survival than those who did not (median survival, 9.0 months vs. 4.3 months).

Reference

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