WCLC 2018 — NSCLC: patient age influences clinical outcomes


  • Brian Hoyle
  • Univadis
Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten. Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten.

Takeaway

  • OS for patients with NSCLC is significantly and detrimentally influenced by increasing age, with outcomes in elderly patients with stage I disease markedly worse vs outcomes in patients with stage III and IV disease.

Why this matters

  • Although treatment of NSCLC is advancing, clinical outcomes and optimal treatments remain unclear for patients of different ages.
  • Analysis of nationwide data on age can clarify demographic, clinical, and socioeconomic factors that are influential, and can assist in selecting treatment strategies.

Study design

  • Retrospective analysis of the National Cancer Database with incident cases of NSCLC from 2004 to 2014.
  • International Classification of Diseases for Oncology, 3rd edition, codes based on cell histology were used to identify patients with squamous cell, large cell, adenocarcinoma, adenosquamous sarcomatoid, and other types of NSCLC.
  • Carcinoid tumors, other neuroendocrine tumors, and metastatic tumors to the lung were excluded.
  • OS was analyzed according to age at the time of diagnosis.

Key results

  • 2,327,158 patients with NSCLC were studied.
  • Median OS for patients with stage I lung cancer aged
  • Median OS for patients with stage II lung cancer aged
  • Median OS for patients with stage III lung cancer aged
  • Median OS for patients with stage IV lung cancer aged
  • Difference with age for each stage was significant (P<.0001>
  • Younger age was associated with larger tumor size at diagnosis.
  • Patients ≥80 years received less standard therapy, including surgery, radiation therapy, or chemotherapy (P<.0001>

Expert comment

  • "Elderly patients with a diagnosis of NSCLC are associated with poor survival across all stages. The different in [OS] is more remarkable in patients with stage I and II than those with stage III and IV. Undertreatment in elderly patients might contribute to the poor survival," said presenter Yanyan Lou, MD, PhD, Mayo Clinic, Jacksonville, Florida.