Use of adjuvant chemotherapy for nonsmall cell lung cancer: Is advanced age a prognostic factor?

Purpose: In patients with nonsmall cell lung cancer (NSCLC), the effect of age on adjuvant chemotherapy (CT) after primary surgical treatment is controversial. The aim of this study was to investigate the effect of age and other clinical variables on survival in NSCLC patients who received adjuvant CT.

Materials And Methods: NSCLC patients who underwent primary resection and received adjuvant CT between January 2012 and January 2016 were included in the study. The patients were divided into two age groups: (1) patients >65 years old (older patient group) and (2) patients ≤ 65 years old (young patient group). The effects of clinical variables such as age, histology, pT stage, pN stage, pTNM stage, adjuvant thoracic radiotherapy, and recurrence status on survival were assessed using the log-rank test and multivariable Cox regression analysis.

Results: A total of 91 NSCLC patients who received adjuvant CT after complete resection were included in the study. The median age of the patients was 60 (36-73) years. Eighty-six percent of the patients were male. 49.4% had squamous NSCLC and 50.6% had nonsquamous NSCLC. 59% had stage I and II disease and 41% had stage III disease. The mean overall survival was 61.9 months [95% confidence interval (CI) 51.28-72.69] in the young patient group and 73.1 months (95% CI 60.24-85.94) in the older patient group . The mean disease-free survival was 47.0 months (95% CI 37.81-56.23) in the young patient group and 51.1 months (95% CI 40.68-57.17) in the older patient group (P = 0.119 and P = 0.407, respectively). Pathological stage III [heart rate (HR): 2.615, P = 0.014] and presence of recurrence (HR: 2.496, P = 0.019) were found to be independent risk factors. However, age did not show statistical significance (HR: 0.428, 95% CI 0.128-1.427, P = 0.167).

Conclusion: In NSCLC patients who underwent complete resection and received adjuvant CT, advanced age had no prognostic effect on survival.