TY - JOUR
TI - Non small cell lung cancer in the elderly: Clinico-pathologic, management and outcome characteristics in comparison to younger patients
AU - Koumarianou, A.
AU - Fountzilas, G.
AU - Kosmidis, P.
AU - Klouvas, G.
AU - Samantas, E.
AU - Kalofonos, C.
AU - Pentheroudakis, G.
AU - Economopoulos, T.
AU - Pectasides, D.
JO - Journal of Chemotherapy
PY - 2009
VL - 21
TODO - 5
SP - 573-583
PB - Maney Publishing
SN - 1120-009X, 1973-9478
TODO - 10.1179/joc.2009.21.5.573
TODO - carboplatin;  cisplatin;  docetaxel;  etoposide;  gemcitabine;  ifosfamide;  paclitaxel;  vinblastine;  vinblastine sulfate;  vindesine;  antineoplastic agent, adult;  age distribution;  aged;  article;  cancer chemotherapy;  cancer radiotherapy;  cancer registry;  cancer staging;  cancer surgery;  cancer survival;  clinical trial;  combination chemotherapy;  controlled study;  coughing;  disease course;  dyspnea;  fatigue;  female;  groups by age;  histopathology;  human;  lung adenocarcinoma;  lung non small cell cancer;  lung squamous cell carcinoma;  major clinical study;  male;  multiple cycle treatment;  outcome assessment;  overall survival;  patient care;  thorax pain;  treatment outcome;  adenocarcinoma;  adjuvant chemotherapy;  adjuvant therapy;  age;  cohort analysis;  comparative study;  large cell carcinoma;  lung non small cell cancer;  lung tumor;  metastasis;  middle aged;  mortality;  multimodality cancer therapy;  pathology;  prognosis;  register;  squamous cell carcinoma;  survival rate, Adenocarcinoma;  Age Factors;  Aged;  Antineoplastic Combined Chemotherapy Protocols;  Carcinoma, Large Cell;  Carcinoma, Non-Small-Cell Lung;  Carcinoma, Squamous Cell;  Chemotherapy, Adjuvant;  Cohort Studies;  Combined Modality Therapy;  Female;  Humans;  Lung Neoplasms;  Middle Aged;  Neoplasm Staging;  Prognosis;  Radiotherapy, Adjuvant;  Registries;  Survival Rate;  Treatment Outcome
TODO - 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 ≥70, 1374 age 70-45 years old and 115 patients aged ≤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. © E.S.I.F.T srl.
ER -