EVALUATION OF FACTORS INFLUENCING SURVIVAL IN FRAGILE PATIENTS WITH NON-SMALL CELL LUNG CANCER
Abstract
Aim: This study aims to evaluate factors affecting long-term prognosis in geriatric patients undergoing anatomical resection for non-small cell lung cancer (NSCLC).
Materials and Methods: A total of 795 patients aged 65 years and above who underwent surgical resection for NSCLC between 2011 and 2020 were evaluated retrospectively. The study population was stratified into two age-based cohorts: patients aged between 65 and 75 years (Group 1) and those older than 75 years (Group 2). Comparisons between groups were made regarding gender, pathological TNM stage, pathological subtype, and Charlson Comorbidity Index (CCI).
Results: Kaplan-Meier analysis demonstrated an average survival time of 61 months for male patients and 74 months for female patients (p=0.056). Survival time was 69 months for right-sided resections and 57 months for left-sided resections (p=0.011). The median survival was 65 months for patients in Group 1 and 51 months for those in Group 2 (p=0.045). According to the Charlson Comorbidity Index, patients scoring 1-3 had an average survival of 78 months, those scoring 4-5 had 63 months, and those with scores above 5 had 45 months (p< 0.001). Average survival was 68 months in patients undergoing lobectomy, compared to 43 months in those undergoing pneumonectomy (p< 0.001).
Conclusions: This study reveals that gender, surgical technique, and comorbidities significantly affect survival outcomes in elderly patients receiving surgical treatment for NSCLC. These findings are critical for determining optimal surgical strategies and optimizing therapeutic approaches in elderly patient populations.
Keywords
Non-Small Cell Lung Carcinoma , Survival Analysis , Prognosis , Treatment Outcome
Kaynakça
- 1. Lin YJ, Chiang XH, Lu TP, Hsieh MS, Lin MW, Hsu HH, et al. Thoracoscopic lobectomy versus sublobar resection for pStage I geriatric non-small cell lung cancer. Front Oncol. 2022;11:777590.
- 2. Radovic M, Kanesvaran R, Rittmeyer A, Früh M, Minervini F, Glatzer M, et al. Multidisciplinary treatment of lung cancer in older patients: A review. J Geriatr Oncol. 2019;10(3):405–10.
- 3. Barta JA, Zinner RG, Unger M. Lung cancer in the older patient. Clin Geriatr Med. 2017;33(4):563–77.
- 4. Howington JA, Blum MG, Chang AC, Balekian AA, Murthy SC. Treatment of stage I and II non-small cell lung cancer: Diagnosis and management of lung cancer: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5):e278S-e313S.
- 5. Lardinois D, De Leyn P, Van Schil P, Rami Porta R, Waller D, Passlick B, et al. ESTS guidelines for intraoperative lymph node staging in non-small cell lung cancer. academic.oup.comD Lardinois, P De Leyn, P Van Schil, RR Porta, D Waller, B Passlick, M Zielinski, K JunkerEuropean journal of cardio-thoracic surgery, 2006•academic.oup.com [Internet]. 2006 [cited 2025 Mar 18]; Available from: https://academic.oup.com/ejcts/article-abstract/30/5/787/365261
- 6. Gonzalez-Aragoneses F, … NMMC reviews in, 2009 undefined. Lung cancer surgery in the elderly. ElsevierF Gonzalez-Aragoneses, N Moreno-Mata, C Simon-Adiego, R Peñalver-PascualCritical reviews in oncology/hematology, 2009•Elsevier [Internet]. [cited 2025 Mar 18]; Available from: https://www.sciencedirect.com/science/article/pii/S1040842808002461
- 7. Bravo-Iñiguez C, Perez Martinez M, Armstrong KW, Jaklitsch MT. Surgical resection of lung cancer in the elderly. Thorac Surg Clin. 2014;24(4):371–81.
- 8. Kent M. Lung Cancer Surgery in the Elderly: Age Is Just a Number. Semin Thorac Cardiovasc Surg. 2017 Feb 4;29(4):548–9.
- 9. Stamenovic D, Messerschmidt A, Schneider T. Surgery for lung tumors in the elderly: A retrospective cohort study on the influence of advanced age (over 80 years) on the development of complications by using a multivariate risk model. International Journal of Surgery. 2018 Apr 1;52:141–8.
- 10. Onaitis MW, Furnary AP, Kosinski AS, Kim S, Boffa D, Tong BC, et al. Prediction of long-term survival after lung cancer surgery for elderly patients in The Society of Thoracic Surgeons General Thoracic Surgery Database. Ann Thorac Surg. 2018;105(1):309–16.