Background This study analyzes the impact of age on perioperative outcomes and long-term survival of patients undergoing surgery after induction chemotherapy for non-small cell lung cancer. Methods Short- and long-term outcomes of patients with non-small cell lung cancer who were at least 70 years and received induction chemotherapy followed by major lung resection (lobectomy or pneumonectomy) from 1996 to 2012 were assessed using multivariable logistic regression, Kaplan-Meier, and Cox proportional hazard analysis. The outcomes of these elderly patients were compared with those of patients younger than 70 years who underwent the same treatment from 1996 to 2012. Results Of the 317 patients who met the study criteria, 53 patients were at least 70 years. The median age was 74 years (range, 70 to 82 years) in the elderly group, and induction chemoradiation was used in 24 (45%) patients. Thirty-day mortality was similar between the younger (n = 12) and elderly (n = 3) patients (5% versus 6%; p = 0.52). There were no significant differences in the incidence of postoperative complications between younger and elderly patients (49% versus 57%; p = 0.30). Patients younger than 70 years had a median overall survival (30 months; 95% confidence interval [CI], 24 to 43) and a 5-year survival (39%; 95% CI, 33 to 45) that was not significantly different from patients at least 70 years (median overall survival, 30 months; 95% CI, 18 to 68; and 5-year overall survival, 36%; 95% CI, 21 to 51). However, there was a trend toward worse survival in the elderly group after multivariable adjustment (hazard ratio, 1.43; 95% CI, 0.97 to 2.12; p = 0.071). Conclusions Major lung resection after induction chemotherapy can be performed with acceptable short-and long-term results in appropriately selected patients at least 70 years, with outcomes that are comparable to those of younger patients.

Collection of sleep quality data among inpatients with AML via a wearable actigraphy device is feasible. AML inpatients appear to have poor sleep quality and quantity, suggesting that sleep issues represent an area of unmet supportive care needs in AML. Further research in this areas is needed to inform the development of interventions to improve sleep duration and quality in hospitalised patients with AML.

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82 Background: Anecdotally, sleep is thought to be a significant problem for inpatients receiving treatment for acute myeloid leukemia (AML), butsleep disturbances in this setting are not well-characterized. We aimed to assess the feasibility of measuring sleep in AML patients using a wearable actigraphy device. Methods: Using the Actigraph GT3X “watch,”we assessed the total sleep time, sleep onset latency, wake after sleep onset, number of awakenings after sleep onset, and sleep efficiency for inpatients with AML receiving induction chemotherapy during their hospitalization. We also assessed patient self-reported sleep quality using the Pittsburgh Sleep Questionnaire Index (PSQI). Results: Of the thirteen patients enrolled in the study, 11 completed actigraphy and PSQI assessments. Two patients who were transferred to the ICU were excluded from this analysis. Data collection was feasible; patients wore the Actigraph device for a mean (SD) of 120 (58) hours. Subjects’ mean age was 55.9 (15.7) years. Mean length of hospitalization was 34 (13) days. The mean PSQI global score was 8.10 (4.91) indicating generally poor sleep. Actigraphy measures also suggested poor sleep. Overall sleep quantity was insufficient, with a mean total sleep time in minutes of 366.5 (61.0). Patients’ sleep was often interrupted, with a mean number of awakenings after sleep onset of 4.9 (3.3), average awakening length in minutes of 7.8 (5.5), and mean wake after sleep onset in minutes of 37.2 (26.4). Mean sleep onset latency in minutes was 0.4 (0.5) and sleep efficiency was high (90.7% (0.1)), suggesting that patients did not have difficulty falling asleep but rather experienced poor sleep due to external factors. Conclusions: Actigraphy assessment of sleep in AML inpatients is feasible, and suggests significant impairments in both quantity and quality of sleep. While patients did not appear to have difficulty falling asleep, they experienced significant sleep disturbances, perhaps from external factors like interactions with staff and interruptions such as from administration of medications, lab draws and vital sign measurements. Supportive care interventions are needed to further improve sleep quantity and quality among inpatients with AML.