title: Outcomes of Major Lung Resection After Induction Therapy for Non-Small Cell Lung Cancer in Elderly Patients.
abstract: BACKGROUND
  This study analyzes the impact of age on perioperative outcomes and long-term survival of patients undergoing surgery after induction chemotherapy for non-small cell lung cancer.
  
  
  METHODS
  Short- and long-term outcomes of patients with non-small cell lung cancer who were at least 70 years and received induction chemotherapy followed by major lung resection (lobectomy or pneumonectomy) from 1996 to 2012 were assessed using multivariable logistic regression, Kaplan-Meier, and Cox proportional hazard analysis. The outcomes of these elderly patients were compared with those of patients younger than 70 years who underwent the same treatment from 1996 to 2012.
  
  
  RESULTS
  Of the 317 patients who met the study criteria, 53 patients were at least 70 years. The median age was 74 years (range, 70 to 82 years) in the elderly group, and induction chemoradiation was used in 24 (45%) patients. Thirty-day mortality was similar between the younger (n = 12) and elderly (n = 3) patients (5% versus 6%; p = 0.52). There were no significant differences in the incidence of postoperative complications between younger and elderly patients (49% versus 57%; p = 0.30). Patients younger than 70 years had a median overall survival (30 months; 95% confidence interval [CI], 24 to 43) and a 5-year survival (39%; 95% CI, 33 to 45) that was not significantly different from patients at least 70 years (median overall survival, 30 months; 95% CI, 18 to 68; and 5-year overall survival, 36%; 95% CI, 21 to 51). However, there was a trend toward worse survival in the elderly group after multivariable adjustment (hazard ratio, 1.43; 95% CI, 0.97 to 2.12; p = 0.071).
  
  
  CONCLUSIONS
  Major lung resection after induction chemotherapy can be performed with acceptable short- and long-term results in appropriately selected patients at least 70 years, with outcomes that are comparable to those of younger patients.
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina.
authors.forename: Chi-Fu Jeffrey
authors.initials: CJ
authors.lastname: Yang
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina.
authors.forename: Nicholas R
authors.initials: NR
authors.lastname: Mayne
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina.
authors.forename: Hanghang
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina.
authors.forename: Ryan R
authors.initials: RR
authors.lastname: Meyerhoff
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina.
authors.forename: Sameer
authors.initials: S
authors.lastname: Hirji
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina.
authors.forename: Betty C
authors.initials: BC
authors.lastname: Tong
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hartwig
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina.
authors.forename: David
authors.initials: D
authors.lastname: Harpole
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: D'Amico
authors.affiliation: Department of Surgery, Duke University, Durham, North Carolina. Electronic address: berry037@stanford.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Berry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D016896:Treatment Outcome