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Narumon Tanatip
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P1.16 - Treatment of Early Stage/Localized Disease (Not CME Accredited Session) (ID 948)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.16-57 - Outcomes of Pulmonary Resection in Elderly Non-Small Cell Lung Cancer Patient (ID 11989)
16:45 - 18:00 | Author(s): Narumon Tanatip
- Abstract
Background
Because of increasing in life span and more than third-fourth of lung cancer patients being age > 60-65 years old, appropriate treatment of old lung cancer patients has become an important issue. The aim of this study is to evaluate the short and long-term surgical outcomes in elderly patients, and to identify prognostic factors of overall mortality.
a9ded1e5ce5d75814730bb4caaf49419 Method
Medical records of patients with non-small cell lung cancer (NSCLC) who underwent pulmonary resection at Chiang Mai University Hospital from January 2002 through December 2016 were retrospectively reviewed. Patients were divided into two groups; age less than 70 years (non-elderly group) and 70 years or more (elderly group). Primary outcome was major post-operative complications and in-hospital death; secondary outcome was long-term survival. Logistic regression and cox proportional hazard model were used to analyze data.
4c3880bb027f159e801041b1021e88e8 Result
This study included 583 patients; 167 in elderly group, and 416 in non-elderly group. Patients in elderly group were more likely to have government insurance, be active smoker, and have a diagnosis of COPD, an abnormal ECG, to undergo a sublobar resection, lymph node sampling, and no chemotherapy treatment than those in the non-elderly group. There were no differences in term of in-hospital mortality, composite post-operative complications, and overall mortality. At multivariable analysis, the composite post-operative complications in the elderly group was not statistically different from the non-elderly group (Adjusted odd ratios = 0.52, 95% CI=0.21-1.28), however the elderly group was more likely to die (HRadj)=2.44, 95%CI=1.26-4.74). Adverse prognostic factors for overall mortality in elderly patients were a poorly differentiated tumor (HRadj=3.53, 95%CI=1.45-8.61) and the presence with perineural invasion (HRadj=3.95, 95%CI=1.14-13.77)
Table 1 prognostic factors for overall mortality of elderly NSCLC patients after pulmonary resection
Variables
Hazard Ratio
95% CI
p-value
Male vs Female
1.43
0.62-3.26
0.401
Smoking amount
≥20 pack-year
0.91
0.45-1.82
0.783
Stage of cancer
Stage I
1.00
Reference
Stage II
0.76
0.36-1.57
0.452
Stage III
2.18
0.92-5.16
0.077
Stage IV
1.70
0.53-5.46
0.373
Grading of cell differentiation
Well
1.00
Reference
Moderately
0.80
0.39-1.67
0.558
Poorly
3.53
1.45-8.61
0.006
Undifferentiated
1.72
0.41-7.31
0.462
Intratumoral lymphatic invasion
2.73
0.99-7.52
0.052
Intratumoral vascular invasion
1.76
0.91-3.39
0.092
Perineural invasion
3.95
1.14-13.77
0.031
SLND versus SLNS
0.51
0.24-1.10
0.084
Chemotherapy
No chemotherapy
1.00
Reference
Adjuvant or induction therapy
0.69
0.33-1.46
0.330
1st-line treatment
0.76
0.15-3.80
0.734
Sublobar resection versus lobectomy
1.78
0.65-4.90
0.261
8eea62084ca7e541d918e823422bd82e Conclusion
Surgery in elderly NSCLC is a safe procedure. Patients presenting with perineural invasion and poorly differentiated tumor should be further considered for possible adjuvant treatment.
6f8b794f3246b0c1e1780bb4d4d5dc53
