2019 STS: Can Patients Over Age 90 Benefit From NSCLC Treatment?
Posted: Wednesday, January 30, 2019
Can patients with non–small cell lung cancer (NSCLC) who are 90 years of age or older benefit from treatment? According to a recent national analysis of outcomes, treatment of such nonagenarian patients should not be withheld based solely on age. In fact, the investigators noted, therapy may offer a survival benefit for many of these older individuals. These findings were presented by C. J. Yang, MD, of Stanford University, California, and colleagues from Duke University, North Carolina, at the 2019 Annual Meeting of the Society of Thoracic Surgeons (STS) in San Diego.
“Most clinicians will encounter patients 90 years or older with lung cancer, but there is currently no available evidence to inform decision-making regarding treatment for this extremely elderly population,” the investigators noted. “Evaluation [of patients 90 years of age and older with NSCLC] at a specialized center should be considered before deeming patients inappropriate for treatment.”
The investigators focused on 7,756 patients aged 90 years or older with NSCLC, who represented 0.6% of patients with NSCLC in the National Cancer Data Base from 2004 to 2014. They evaluated the predictors of practice patterns for these patients, which included the use of surgery, chemotherapy, radiation therapy, and no treatment.
The majority of the nonagenarian patients with stages I to IV NSCLC (58%) did not receive any therapy. Factors that appeared to increase the likelihood of receiving therapy included treatment at an academic center, male sex, lower comorbidities scores, and lower disease stage.
In terms of outcomes, receiving treatment was significantly associated with better 5-year survival than not receiving treatment (9.7% vs. 1.8%). More specifically, the 1,556 nonagenarian patients with stage I disease, surgery was linked to significantly better 5-year and median survival than nonoperative therapy (34% and 42 months vs. 17% and 24 months) and no therapy (7% and 10 months).
Disclosure: The study authors’ disclosure information can be found at sts.org.
