Τίτλος:
Non small cell lung cancer in the elderly: Clinico-pathologic, management and outcome characteristics in comparison to younger patients
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Koumarianou, A.
Fountzilas, G.
Kosmidis, P.
Klouvas, G.
Samantas, E.
Kalofonos, C.
Pentheroudakis, G.
Economopoulos, T.
Pectasides, D.
Περιοδικό:
Journal of Chemotherapy
Εκδότης:
Maney Publishing
Λέξεις-κλειδιά:
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
DOI:
10.1179/joc.2009.21.5.573
