Abstract
Objective:Even though there have been considerable improvements in the diagnosis and treatment of lung cancer, the prognostic factors for elderly patients with advanced nonsmall-cell lung cancer (NSCLC) remain insufficient. Therefore, our aim is to compare the prognostic factors for elderly and young cases with advanced stage NSCLC.Methods:The data of 370 advanced stage young (<65 years old) and elderly (≥65 years old) NSCLC patients (Stage IIIB or IV) treated between 1995 and 2008 were retrospectively evaluated for the study at the oncology department. Demographic characteristics, treatment response, comorbidities, pleural effusion, performance status, and overall survival (OS) were correlated with patient clinical features and smoking habits at the time of diagnosis.Results:Of the 370 patients, 284 (76.8%) were in the younger group and 86 (23.2%) were in the older group. The rates of stages (IIIB, IV) were similar in the elderly and younger groups. At the time of diagnosis, poor performance status, comorbidity, weight loss, anemia, and smoking status were more effective prognostic factors for elderly cases than younger ones. The treatment responses were also significantly different between the two age groups when the presenting symptom was weight loss: 18.7% of the younger group had progressive disease compared with 57.1% of the older group (P = 0.017).Conclusion:We concluded that treatment responses of the younger group were less affected by weight loss. These analyses suggest that weight loss at presentation can be useful in predicting disease response in patients with advanced stage elderly NSCLC.
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References
References1. Ministry of Health Department of Cancer Control. Cancer Control Programme and Cancer Statistics in Turkey (1995–1999). Ankara, Ministry of Health Department of Cancer Control, 2002, pp 135–161.Ministry of Health Department of Cancer ControlCancer Control Programme and Cancer Statistics in Turkey (1995–1999).AnkaraMinistry of Health Department of Cancer Control2002135-1612. Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997;111:1710–1717.MountainCFRevisions in the international system for staging lung cancer.Chest19971111710-17173. van Dijck JA, Festen J, de Kleijn EM, et al; Working Group on Lung Cancer of the Comprehensive Cancer Centre East. Treatment and survival of patients with non-small cell lung cancer stage IIIA diagnosed in 1989–1994: a study in the region of the Comprehensive Cancer Centre East, The Netherlands. Lung Cancer 2001;34:19–27.van DijckJA]]FestenJ]]de KleijnEM&etal;Working Group on Lung Cancer of the Comprehensive Cancer Centre EastTreatment and survival of patients with non-small cell lung cancer stage IIIA diagnosed in 1989–1994: a study in the region of the Comprehensive Cancer Centre East, The Netherlands.Lung Cancer20013419-274. Socinski MA, Morris DE, Masters GA, et al. Chemotherapeutic management of stage IV non-small cell lung cancer. Chest 2003;123:226S–243S.SocinskiMA]]MorrisDE]]MastersGA&etal;Chemotherapeutic management of stage IV non-small cell lung cancer.Chest2003123226S-243S5. Cornere MM, Fergusson W, Kolbe J, et al. Characteristics of patients with lung cancer under the age of 45 years: a case control study. Respirology 2001;6:293–296.CornereMM]]FergussonW]]KolbeJ&etal;Characteristics of patients with lung cancer under the age of 45 years: a case control study.Respirology20016293-2966. Ramalingam S, Pawlish K, Gadgeel S, et al. Lung cancer in young patients: analysis of a surveillance, epidemiology, and end results database. J Clin Oncol 1998;16:651–657.RamalingamS]]PawlishK]]GadgeelS&etal;Lung cancer in young patients: analysis of a surveillance, epidemiology, and end results database.J Clin Oncol199816651-6577. Radzikowska E, Roszkowski K, Głaz P. Lung cancer in patients under 50 years old. Lung Cancer 2001;33:203–211.RadzikowskaE]]RoszkowskiK]]GłazPLung cancer in patients under 50 years old.Lung Cancer200133203-2118. Costa GJ, Fernandes AL, Pereira JR, et al. Survival rates and tolerability of platinum-based chemotherapy regimens for elderly patients with non-small-cell lung cancer (NSCLC). Lung Cancer 2006;53:171–176.CostaGJ]]FernandesAL]]PereiraJR&etal;Survival rates and tolerability of platinum-based chemotherapy regimens for elderly patients with non-small-cell lung cancer (NSCLC).Lung Cancer200653171-1769. Rocha MP, Fraire AE, Guntupalli KK, et al. Lung cancer in the young. Cancer Detect Prev 1994;18:349–355.RochaMP]]FraireAE]]GuntupalliKK&etal;Lung cancer in the young.Cancer Detect Prev199418349-35510. Temel J. Can weight loss at presentation predict patient outcome in lung cancer? Nat Clin Pract Oncol 2004;1:68–69.TemelJCan weight loss at presentation predict patient outcome in lung cancer?Nat Clin Pract Oncol2004168-6911. Ludbrook JJ, Truong PT, MacNeil MV, et al. Do age and comorbidity impact treatment allocation and outcomes in limited stage small-cell lung cancer? A community-based population analysis. Int J Radiat Oncol Biol Phys 2003;55:1321–1330.LudbrookJJ]]TruongPT]]MacNeilMV&etal;Do age and comorbidity impact treatment allocation and outcomes in limited stage small-cell lung cancer? A community-based population analysis.Int J Radiat Oncol Biol Phys2003551321-133012. Dajczman E, Fu LY, Small D, et al. Treatment of small cell lung carcinoma in the elderly. Cancer 1996;77:2032–2038.DajczmanE]]FuLY]]SmallD&etal;Treatment of small cell lung carcinoma in the elderly.Cancer1996772032-203813. Langer CJ, Manola J, Bernardo P, et al. Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of Eastern Cooperative Oncology Group 5592, a randomized trial. J Natl Cancer Inst 2002;94:173–181.LangerCJ]]ManolaJ]]BernardoP&etal;Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of Eastern Cooperative Oncology Group 5592, a randomized trial.J Natl Cancer Inst200294173-18114. Ak G, Metintas M, Metintas S, et al. Lung cancer in individuals less than 50 years of age. Lung 2007;185:279–286.AkG]]MetintasM]]MetintasS&etal;Lung cancer in individuals less than 50 years of age.Lung2007185279-28615. Skarin AT, Herbst RS, Leong TL, et al. Lung cancer in patients under age 40. Lung Cancer 2001;32:255–264.SkarinAT]]HerbstRS]]LeongTL&etal;Lung cancer in patients under age 40.Lung Cancer200132255-26416. Bourke W, Milstein D, Giura R, et al. Lung cancer in young adults. Chest 1992;102:1723–1729.BourkeW]]MilsteinD]]GiuraR&etal;Lung cancer in young adults.Chest19921021723-172917. Green LS, Fortoul TI, Ponciano G, et al. Bronchogenic cancer in patients under 40 years old: the experience of a Latin American country. Chest 1993;104:1477–1481.GreenLS]]FortoulTI]]PoncianoG&etal;Bronchogenic cancer in patients under 40 years old: the experience of a Latin American country.Chest19931041477-148118. Jubelirer SJ, Wilson RA. Lung cancer in patients younger than 40 years of age. Cancer 1991;67:1436–1438.JubelirerSJ]]WilsonRALung cancer in patients younger than 40 years of age.Cancer1991671436-143819. Maruyama R, Yoshino I, Yohena T, et al. Lung cancer in patients younger than 40 years of age. J Surg Oncol 2001;77:208–212.MaruyamaR]]YoshinoI]]YohenaT&etal;Lung cancer in patients younger than 40 years of age.J Surg Oncol200177208-21220. Kuo CW, Chen YM, Chao JY, et al. Non-small cell lung cancer in very young and very old patients. Chest 2000;117:354–357.KuoCW]]ChenYM]]ChaoJY&etal;Non-small cell lung cancer in very young and very old patients.Chest2000117354-35721. Mandrekar SJ, Schild SE, Hillman SL, et al. A prognostic model for advanced stage nonsmall cell lung cancer. Pooled analysis of North Central Cancer Treatment Group trials. Cancer 2006;107:781–792.MandrekarSJ]]SchildSE]]HillmanSL&etal;A prognostic model for advanced stage nonsmall cell lung cancer. Pooled analysis of North Central Cancer Treatment Group trials.Cancer2006107781-79222. Cağlayan B, Fidan A, Salepçi B, et al. Effects of prognostic factors and treatment on survival in advanced non-small cell lung cancer. Tuberk Toraks 2004;52:323–332.CağlayanB]]FidanA]]SalepçiB&etal;Effects of prognostic factors and treatment on survival in advanced non-small cell lung cancer.Tuberk Toraks200452323-332
