Survival and outcomes of surgical treatment of the elderly NSCLC in China: a retrospective matched cohort study.
OBJECTIVE
To compare survival and outcomes of pulmonary resection for elderly NSCLC patients with that of younger controls in China.


METHODS
A database which included 4792 NSCLC patients who received complete surgery from 1985 to 2005 was used. The elderly patients (>or=70) were matched 1:1 to controls (<70) by 5 variables: gender; stage; histology; pulmonary resection types; adjuvant chemotherapy. The long-term survival rates, the operative mortality and short-term death after surgery were compared.


RESULTS
There were 1304 patients: 652 cases were >or=70. The 5-year OS of elderly was 39%; that of the controls was 45% (p=0.06). Operative mortality rate between elderly and the controls was similar (9/652 vs 4/652 p=0.16) but the short-term death within 2 months after the surgeries were different (23/652 vs 7/652 p=0.003). The elderly with lobectomy had a worse 5-year OS than controls (42% vs 46% p=0.05), but the 5-year OS was similar for patients who received pneumonectomy (24% vs 36% p=0.40) and the limited resections (46% vs 39% p=0.27). The 5-year OS in patients who received adjuvant chemotherapy were similar (49% vs 44% p=0.10).


CONCLUSIONS
Elderly have the similar long-term OS with the controls. They should not be denied the curative surgery and adjuvant chemotherapy based on their chronologic age. However, elderly patients had a higher risk of short-term death after the surgery, which suggests that elderly be given more intensive care after the surgery.
Fan
J
J
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, 507 Zheng Min Rd, Yangpu District, Shanghai 200433, PR China.
Wang
X J
XJ
Jiang
G N
GN
Wang
L
L
Zu
X W
XW
Zhou
X
X
Gao
W
W
Ding
J A
JA
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome