Non small cell lung cancer in the elderly: clinico-pathologic, management and outcome characteristics in comparison to younger patients.
Τίτλος | Non small cell lung cancer in the elderly: clinico-pathologic, management and outcome characteristics in comparison to younger patients. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Koumarianou, A., Fountzilas G., Kosmidis P., Klouvas G., Samantas E., Kalofonos C., Pentheroudakis G., Economopoulos T., & Pectasides D. |
Journal | J Chemother |
Volume | 21 |
Issue | 5 |
Pagination | 573-83 |
Date Published | 2009 Nov |
ISSN | 1973-9478 |
Λέξεις κλειδιά | Adenocarcinoma, Age Factors, Aged, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Large Cell, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Chemotherapy, Adjuvant, Cohort Studies, Combined Modality Therapy, Female, Humans, Lung Neoplasms, Middle Aged, Neoplasm Staging, Prognosis, Radiotherapy, Adjuvant, Registries, Survival Rate, Treatment Outcome |
Abstract | It is controversial whether non-small cell lung cancer (NSCLC) in the elderly constitutes a distinct clinico-biological entity compared to younger counterparts. As reported data are scant and discordant, we sought to analyze retrospectively the medical records of Hellenic NSCLC patients aged >70 years and compare them with those of age (70-45 years) and younger (<45 years) patients. Records were abstracted from the Hellenic Cooperative Oncology Group (HeCOG) cancer registry database. Presentation, management and outcome data of 417 elderly patients aged > or =70, 1374 age 70-45 years old and 115 patients aged < or =45 years old with histologically confirmed NSCLC managed from 1989 until 2004 were retrieved and compared. Elderly patients differed significantly in terms of presence of symptoms (p<0.001), including thoracic pain (p=0.003), dyspnea (p<0.001), cough (p<0.001) and fatigue (p<0.001), eastern Cooperative Oncology Group performance status (PS) 2-3 (p<0.001), and histological type (more commonly diagnosed with squamous cell carcinoma (p<0.002) and less frequently with adenocarcinoma). Although elderly patients had significantly higher rates of PS 2-3, they had significantly better median time to disease progression (TTP) compared to the younger counterpart (6.4 versus 4.3 months p=0.047). Overall survival (OS) was not significantly different between elderly and young patients (median OS 11.8 versus 11.5 months; p=0.6), but platinum-based chemotherapy and radiotherapy were variables associated favorably with TTP and survival in the elderly. This large retrospective series presents strong evidence that NSCLC constitutes a similar clinicopathologic entity in elderly and young individuals with discretely differing biological behavior and that elderly symptomatic patients should be considered for effective anticancer treatment whenever possible. |
DOI | 10.1179/joc.2009.21.5.573 |
Alternate Journal | J Chemother |
PubMed ID | 19933050 |