title: Management of non-small cell lung cancer in the elderly.
abstract: Most developed countries accepted the chronological age of 70 years as the definition of "elderly" and there is a general consensus in clinical practice to consider this age as the threshold in risk assessment. This has a strong impact in the choice of treatment of these lung cancer patients. Indeed, more than 50% of these patients are over 70 and nearly 30% are over 75 years old. Because of the increasing number of elderly patients that are generally fitter than in the past, the treatment options should rather be based on individual fitness, taking into account risks and benefits of the diagnostic and therapeutic procedures. This means considering biological rather than chronological age to make decisions. For these reasons, we developed a simplified short comprehensive geriatric assessment (sCGA), including a standardised evaluation of activity of daily living, depression, cognitive status, comorbidities and geriatric syndromes. This allowed us the classification of these patients into 3 categories: frail, vulnerable and fit. Through the emblematic case of a fit elderly man affected by NSLCC, we present the multidisciplinary assessment and discussions to identify the best treatment options for this patient.
authors.affiliation: Department of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. Electronic address: patrizia.froesch@eoc.ch.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Froesch
authors.affiliation: Department of Radiotherapy, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
authors.forename: Francesco
authors.initials: F
authors.lastname: Martucci
authors.affiliation: Department of Internal Medicine and Pulmonology, ORBV, Bellinzona, Switzerland.
authors.forename: Sandor
authors.initials: S
authors.lastname: Györik
authors.affiliation: Referral center for Thoracic Surgery in Ticino, ORBV, Bellinzona, Switzerland.
authors.forename: André Emanuel
authors.initials: AE
authors.lastname: Dutly
authors.affiliation: Referral center for Thoracic Surgery in Ticino, ORBV, Bellinzona, Switzerland.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cafarotti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D019468:Disease Management; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male
keywords: Elderly; Geriatric assessment; Non small cell lung cancer