Introduction: Patterns of treatment and survival are largely unknown for older patients with stage III non-small cell lung cancer (NSCLC) in daily clinical practice.
Methods: All patients ≥65 years with stage III NSCLC (2009-2013) were included from the population-based Netherlands Cancer Registry. Descriptive and multivariable treatment and survival analyses were stratified for patients aged 65-74 years and ≥75 years.
Results: Compared to older patients (n = 3163), those aged 65-74 years (n = 3876) underwent more often surgery (21% vs 12% for stage IIIA), chemoradiotherapy (47% vs 22% for both stage IIIA and IIIB), and chemotherapy (23% vs 12% for stage IIIB), and received less radiotherapy (8% vs 22% for both stage IIIA and IIIB). One-year survival was significantly higher among patients aged 65-74 compared to those aged ≥75 (61% vs 43%, for stage IIIA and 45% vs 30% for stage IIIB; P < .01). However, stratification of treatment showed similar survival rates between age groups. Among patients aged 65-74 years, the multivariably adjusted hazard ratio (HR) of death was twice as high for patients receiving radiotherapy (HR 1.9 (95%CI 1.6-2.2) for stage IIIA and HR 2.5 (95%CI 2.1-3.0) for stage IIIB) and chemotherapy (HR 2.2 (95%CI 1.9-2.5) and HR 2.2 (95%CI 1.8-2.7), respectively) compared to chemoradiotherapy, and were slightly lower for patients aged ≥75 years receiving radiotherapy (HR 1.6 (95%CI 1.4-1.9) and HR 1.8 (95%CI 1.5-2.1), respectively) and chemotherapy (HR 2.2 (95%CI 1.8-2.7) and HR 1.8 (95%CI 1.5-2.2), respectively). Comorbidity was not significantly associated with poorer survival (p = .07).
Conclusion: Chemoradiotherapy was more often applied among patients aged 65-74 years compared to those aged ≥75. While survival was worse for patients aged ≥75 years, differences between age groups largely disappeared after stratification for treatment. Future research should focus on predictive patient characteristics to distinguish patients within the heterogeneous older population who can benefit from curative-intent treatment.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.lungcan.2017.12.013 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Prognostic impact of the N2 subclassification and stage migration in the ninth edition of the TNM classification in surgically resected lung cancer.
Lung Cancer
December 2024
Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan.
Objectives: In the ninth edition of the TNM classification of lung cancer, N2 is subdivided into single-station (N2a) and multiple-station involvement (N2b), and some stage changes are made to stage II-III. This study aimed to validate the new classification and determine the effect of stage migration and vice versa on the prognosis of each pathological stage due to these changes.
Materials And Methods: A total of 1,754 patients with surgically resected lung cancer were included.
Interstitial lung diseases with concomitant lung cancer: a data mining approach revealing a complex condition with gender- and immune-associated specific implications.
Front Oncol
December 2024
Department of Internal Medicine and Medical Therapeutics, University of Pavia Medical School, Pavia, Italy.
Background: Interstitial lung diseases (ILDs) comprise a family of heterogeneous entities, primarily characterised by chronic scarring of the lung parenchyma. Among ILDs, idiopathic pulmonary fibrosis (IPF) is the most common idiopathic interstitial pneumonitis, associated with progressive functional decline leading to respiratory failure, a high symptom burden, and mortality. Notably, the incidence of lung cancer (LC) in patients already affected by ILDs-mainly IPF-is significantly higher than in the general population.
View Article and Find Full Text PDFEGFR status assessment using reflex testing targeted next-generation sequencing for resected non-squamous non-small cell lung cancer.
Virchows Arch
December 2024
Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d'Azur, CHU Nice, FHU OncoAge, IHU RespirERA, Nice, France.
EGFR status assessment is mandatory for adjuvant decision-making of resected stage IB-IIIA non-squamous non-small cell lung cancer (NS-NSCLC). It is questionable whether single-gene RT-PCR versus next-generation sequencing (NGS) should be used for this evaluation. Moreover, co-occurring mutations have an impact on tumor behavior and may influence future therapeutic decision-making.
View Article and Find Full Text PDFCase Report: Avoiding misdiagnosis in amyloidosis-navigating transthyretin genopositivity and monoclonal gammopathy in a patient with advanced heart failure and spinal stenosis.
Front Cardiovasc Med
December 2024
Division of Hematology-Oncology, Department of Medicine, Tufts Medical Center, Boston, MA, United States.
Background: A 63-year-old Black woman presented with progressive exertional dyspnea and chronic lower back pain. The course and findings in her case are instructive.
Case Report: Family history was notable for cardiac deaths.
Coexisting growing teratoma syndrome and gliomatosis peritonei following ovarian immature teratoma: a case report and literature review.
Turk J Med Sci
December 2024
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Health Sciences, Ankara, Turkiye.
Growing teratoma syndrome (GTS) is characterized by a reduction in serum tumor markers despite the growth of a benign mature teratomatous mass following chemotherapy for germ cell tumors. Gliomatosis peritonei (GP) typically accompanies ovarian teratomas, marked by the dissemination of mature glial tissue across the peritoneum. The concurrent presence of GTS and GP after treatment for ovarian immature teratoma (IMT) is notably rare, with approximately 20 reported cases.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!