Management of elderly patients with NSCLC; updated expert's opinion paper: EORTC Elderly Task Force, Lung Cancer Group and International Society for Geriatric Oncology

Pallis, Athanasios; Gridelli, Cesare; Wedding, Ulrich; Faivre-Finn, Corinne; Veronesi, Giulia; Jaklitsch, Michael T.; Luciani, Andrea; O’Brien, Mary

doi:10.1093/annonc/mdu022

Cited by 158 publications

(124 citation statements)

References 107 publications

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“…And it is now widely accepted that the surgical treatment of NSCLC in the elderly is feasible and that age per se is not a contraindication for various surgical procedures. 13) However, the main findings of this study showed that the radical lobectomy achieved similar disease-free survival but failed in overall survival for the elderly lung cancer patients comparing with the younger patients. The similar results were reported by Kamiyoshihara.…”

Section: Discussionmentioning

confidence: 64%

Outcome of VATS Lobectomy for Elderly Non-Small Cell Lung Cancer: A Propensity Score-Matched Study

Sui

Zhao

Wang

et al. 2015

ATCS

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Purpose: To analyze the short-term and long-term outcome of video-assisted thoracic surgery (VATS) lobectomy for elderly patients with non-small cell lung cancer. Methods: 105 patients aged ≥75 years with resected non-small cell lung cancer were matched with 105 younger patients by propensity score. Survival rates were calculated by the Kaplan-Meier method. The cumulative incidence functions of conditional survival rate according to the age of the patients were calculated by competing risk analysis. Results: patients ≥75 years was associated with higher postoperative complication rate (p <0.001), but similar perioperative death rate (p = 0.006). Patients ≥75 years were less likely to receive adjuvant chemotherapy (p <0.001). The 5-year overall survival rates were 54.6% for patients ≥75 years and 74.1% for patients <75 years (p = 0.001). No difference was seen in disease-free survival rate (59.5% vs. 71.9% respectively = 0.117). The cumulative incidence functions of 5-year cancer-specific death were similar between the two groups (28.7% vs. 24.6% respectively, p = 0.106). The cumulative incidence functions of 5-year non-cancer-specific death was significantly higher in the elderly group (18.7% vs. 1.0%, p <0.001). Conclusions: VATS lobectomy for non-small-cell lung cancer in patients ≥75 years were feasible with increased morbidity but similar mortality. The resected elderly patients were more frequently associated with non-cancer-specific death.

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Section: Discussionmentioning

confidence: 64%

Outcome of VATS Lobectomy for Elderly Non-Small Cell Lung Cancer: A Propensity Score-Matched Study

Sui

Zhao

Wang

et al. 2015

ATCS

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“…Median overall survival (OS) was indeed 10.3 months for doublet chemotherapy versus 6.2 months for mono-chemotherapy (hazard ratio 0.64; 95% CI, 0.52-0.78; P<0.0001) (5). From then on, guidelines recommended carboplatin-based doublet for first-line treatment of fit elderly patients and single-agent chemotherapy for less fit patients (6). However, there is no clear definition of fit elderly patients and this population is very heterogeneous.…”

mentioning

confidence: 99%

“…Towards this purpose, the use of a comprehensive geriatric assessment (CGA) is recommended in several guidelines (6). CGA is a multidisciplinary and global approach dedicated to predict the mortality and morbidity of elderly patients diagnosed with cancer and to adapt the cancer treatment in this specific population (8).…”

mentioning

confidence: 99%

Elderly selection on geriatric index assessment

Tomasini

Mascaux²

2016

Ann. Transl. Med.

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“…[4,9] Advanced age has been a prevalent reason for not administering treatment, contrary to established guidelines. [10][11][12] Platinum-based doublet chemotherapy is considered to be standard of care for elderly patients with an Eastern Cooperative Oncology Group Performance Status (ECOG PS) score of 0-1. [13][14] The association of a platinum compound with a third-generation agent improves survival, [15][16] and seems to be the most effective therapeutic choice in such cases.…”

Section: Introductionmentioning

confidence: 99%

Do elderly NSCLC stage IV patients benefit from chemotherapy as well as younger? An analysis from clinical practice date

Gironés¹,

Löpez²,

Chulvi³

et al. 2016

JCMT

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How to cite this article: Gironés R, López P, Chulvi R, Cañabate M. Do elderly NSCLC stage IV patients benefit from chemotherapy as well as younger? An analysis from clinical practice date. J Cancer Metasta Treat 2016;2:379-87. Aim:The aim of this study was to evaluate the efficacy of treatment related to age in metastatic non-small cell lung cancer (NSCLC). We compared young and elders (> 70) in the setting of a regional Spanish hospital. We hypothesized that elder benefit as much as younger patients from chemotherapy in stage IV NSCLC. The study was limited to performance status 0-2. Methods: Clinical and demographic characteristics were reviewed form medical records. Type of treatment was collected and compared, as well as benefit from treatment, in terms of overall survival. Results: 322 patients (162 young, 160 aged) Elderly patients received less active treatment (63% vs. 86%, P = 0.001). Elderly received less chemotherapy, less cisplatin-doublets, more carboplatin-combinations and monotherapy (P = 0.035). The benefits of treatment were similar, regardless of age. Smoking status demonstrated a prognosis impact for elder patients treated with chemotherapy. Those who remained active smokers had a lower overall survival in the aged group. In a multivariate analysis, the Eastern Cooperative Oncology Group, active treatment and non-smoking history were favorable prognostic factors for elder patients. Smoking had not impact on young patients. Conclusion: Elderly patients were undertreated in clinical practice. Treatment showed similar overall survival despite of age. The impact of smoking seems to be more significant in the elderly population. Key words:Non-small cell lung cancer, elderly, chemotherapy, overall survival, smoking habits, platinum-combinations ABSTRACTArticle history:

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Management of elderly patients with NSCLC; updated expert's opinion paper: EORTC Elderly Task Force, Lung Cancer Group and International Society for Geriatric Oncology

Cited by 158 publications

References 107 publications

Outcome of VATS Lobectomy for Elderly Non-Small Cell Lung Cancer: A Propensity Score-Matched Study

Outcome of VATS Lobectomy for Elderly Non-Small Cell Lung Cancer: A Propensity Score-Matched Study

Elderly selection on geriatric index assessment

Do elderly NSCLC stage IV patients benefit from chemotherapy as well as younger? An analysis from clinical practice date

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