title: Early Stage Non-Small-Cell Lung Cancer in Octogenarian and Older Patients: A SEER Database Analysis.
abstract: The median age at diagnosis of lung cancer is 70 years. However, the evidence guiding the management of octogenarians and older patients with non-small-cell lung cancer (NSCLC), is based on data derived from younger patients and may not be appropriate.
  
  
  
  Patients ≥ 80 years diagnosed with clinical stages I and II NSCLC, between 1988 and 2007, were identified from the SEER database. Patients were classified according to treatments received: no treatment, surgery only, radiation only, and surgery + radiation. Factors associated with survival were assessed using the Cox proportional hazards model.
  
  
  
  There were 1338 cases of early stage NSCLC in octogenarians. Surgery was the most common treatment modality. The median overall survival was 3.8 years for patients who had surgery, compared with 1.6 years, 1.6 years, and 0.9 years for those who received surgery + radiation, radiation alone, and no treatment, respectively (P < .0001). Factors significantly associated with worse overall survival following surgery included increasing age (hazard ratio [HR], 1.08; P = .0005), male gender (HR, 1.33; P = .01), stage II (HR, 2.21; P < .0001), and squamous histology (HR, 1.36; P = .01).
  
  
  
  Surgical resection is associated with long-term survival outcomes in a substantial proportion of octogenarian and older patients with early stage lung cancer and should not be withheld on the basis of age alone.
authors.affiliation: Department of Internal Medicine, VA Nebraska Western Iowa Health Care System, Omaha, NE; Department of Internal Medicine, Division of Oncology/Hematology, University of Nebraska Medical Center, Omaha, NE. Electronic address: aganti@unmc.edu.
authors.forename: Apar Kishor
authors.initials: AK
authors.lastname: Ganti
authors.affiliation: Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Valerie
authors.initials: V
authors.lastname: Shostrom
authors.affiliation: Department of Clinical Oncology, Ain Shams University Hospitals, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Alorabi
authors.affiliation: Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Weining Ken
authors.initials: WK
authors.lastname: Zhen
authors.affiliation: Department of Internal Medicine, Division of Oncology/Hematology, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Alissa S
authors.initials: AS
authors.lastname: Marr
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, University of Nebraska Medical Center, Omaha, NE; Department of Surgery, VA Nebraska Western Iowa Health Care System, Omaha, NE.
authors.forename: Karin
authors.initials: K
authors.lastname: Trujillo
authors.affiliation: Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE.
authors.forename: K M Monirul
authors.initials: KM
authors.lastname: Islam
authors.affiliation: Department of Surgery, Division of Cardiothoracic Surgery, University of Nebraska Medical Center, Omaha, NE; Department of Surgery, VA Nebraska Western Iowa Health Care System, Omaha, NE.
authors.forename: Rudy P
authors.initials: RP
authors.lastname: Lackner
authors.affiliation: Department of Internal Medicine, Division of Oncology/Hematology, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Anne
authors.initials: A
authors.lastname: Kessinger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011878:Radiotherapy; D012307:Risk Factors; D013514:Surgical Procedures, Operative; D016019:Survival Analysis
keywords: Geriatric; Outcomes; Radiation; Surgery; Survival