TY - JOUR
T1 - Risk of recurrence of resected stage i non-small cell lung cancer in elderly patients as compared with younger patients
AU - Goodgame, Boone
AU - Viswanathan, Avinash
AU - Zoole, Jennifer
AU - Gao, Feng
AU - Miller, C. Ryan
AU - Subramanian, Janakiraman
AU - Meyers, Bryan F.
AU - Patterson, Alexander G.
AU - Govindan, Ramaswamy
PY - 2009/11
Y1 - 2009/11
N2 - Purpose: Half of all patients with non-small cell lung cancer (NSCLC) are 70 years or older at the time of diagnosis. Surgery is an option for fit elderly patients with early stage disease, but rates of disease recurrence after surgical resection are not well described. We report the outcomes in elderly patients (70 years or older) with stage I NSCLC after surgical resection. Patients and Methods: We conducted a retrospective study of patients diagnosed with stage I NSCLC after surgical resection at Washington University School of Medicine-Alvin J. Siteman Cancer Center from 1990 to 2000. Demographic, pathologic, treatment, and follow-up data were collected. Recurrence rates and overall survival were calculated by the Kaplan-Meier method. Multivariate Cox proportional hazards models were used to detect associations between potential prognostic factors and survival and recurrence. Results: Of the 715 patients with stage I NSCLC, 286 were 70 years or older at diagnosis. In this elderly cohort, the median age was 74 years (range, 70-89 years) and 140 of them were women (49%). Lobectomy was performed in 237 patients (83%) whereas 43 patients (15%) had a wedge or segmental resection, and six patients (2%) underwent pneumonectomy. Clinical and pathologic characteristics were not statistically different between the elderly and younger cohorts, with the exception that older patients were more likely to be white (90% versus 80%, p = 0.0003) and less likely to be smokers (88% versus 95%, p = 0.019) compared with the younger cohort. With a median follow-up of 4.6 years, the overall 5-year survival rate was 52% with a 5-year recurrence rate of 24%. In comparison, the patients younger than 70 years had a 5-year survival rate of 67% (p < 0.001) and a 5-year recurrence rate of 24%. ConclusionS: Although overall survival was worse in elderly patients, estimated disease recurrence rates after resection were identical.
AB - Purpose: Half of all patients with non-small cell lung cancer (NSCLC) are 70 years or older at the time of diagnosis. Surgery is an option for fit elderly patients with early stage disease, but rates of disease recurrence after surgical resection are not well described. We report the outcomes in elderly patients (70 years or older) with stage I NSCLC after surgical resection. Patients and Methods: We conducted a retrospective study of patients diagnosed with stage I NSCLC after surgical resection at Washington University School of Medicine-Alvin J. Siteman Cancer Center from 1990 to 2000. Demographic, pathologic, treatment, and follow-up data were collected. Recurrence rates and overall survival were calculated by the Kaplan-Meier method. Multivariate Cox proportional hazards models were used to detect associations between potential prognostic factors and survival and recurrence. Results: Of the 715 patients with stage I NSCLC, 286 were 70 years or older at diagnosis. In this elderly cohort, the median age was 74 years (range, 70-89 years) and 140 of them were women (49%). Lobectomy was performed in 237 patients (83%) whereas 43 patients (15%) had a wedge or segmental resection, and six patients (2%) underwent pneumonectomy. Clinical and pathologic characteristics were not statistically different between the elderly and younger cohorts, with the exception that older patients were more likely to be white (90% versus 80%, p = 0.0003) and less likely to be smokers (88% versus 95%, p = 0.019) compared with the younger cohort. With a median follow-up of 4.6 years, the overall 5-year survival rate was 52% with a 5-year recurrence rate of 24%. In comparison, the patients younger than 70 years had a 5-year survival rate of 67% (p < 0.001) and a 5-year recurrence rate of 24%. ConclusionS: Although overall survival was worse in elderly patients, estimated disease recurrence rates after resection were identical.
KW - Elderly
KW - Lung cancer
KW - Outcomes
KW - Stage I
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=70449580653&partnerID=8YFLogxK
U2 - 10.1097/JTO.0b013e3181b6bc1b
DO - 10.1097/JTO.0b013e3181b6bc1b
M3 - Article
C2 - 19692932
AN - SCOPUS:70449580653
SN - 1556-0864
VL - 4
SP - 1370
EP - 1374
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
IS - 11
ER -