Non small cell lung cancer in the elderly: clinico-pathologic, management and outcome characteristics in comparison to younger patients (Journal article)

Koumarianou, A./ Fountzilas, G./ Kosmidis, P./ Klouvas, G./ Samantas, E./ Kalofonos, C./ Pentheroudakis, G./ Economopoulos, T./ Pectasides, D.

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.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Adenocarcinoma/mortality/pathology/*therapy,Age Factors,Aged,Antineoplastic Combined Chemotherapy Protocols/*therapeutic use,Carcinoma, Large Cell/mortality/secondary/*therapy,Carcinoma, Non-Small-Cell Lung/mortality/secondary/*therapy,Carcinoma, Squamous Cell/mortality/secondary/*therapy,Chemotherapy, Adjuvant,Cohort Studies,Combined Modality Therapy,Female,Humans,Lung Neoplasms/mortality/pathology/*therapy,Middle Aged,Neoplasm Staging,Prognosis,Radiotherapy, Adjuvant,Registries,Survival Rate,Treatment Outcome
ISSN: 1973-9478
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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