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P. López Leiva
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P1.12 - Poster Session/ Community Practice (ID 232)
- Event: WCLC 2015
- Type: Poster
- Track: Community Practice
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.12-009 - Lung Cancer in Octogenarians (ID 2535)
09:30 - 09:30 | Author(s): P. López Leiva
- Abstract
Background:
Octogenarian patients with lung cancer are underestimated in the scientific literature. Since in our institution, the median age of patients with lung cancer is 71 years old, we decide to conduct a study to get specific data of our population over 80 years
Methods:
Retrospective observational cohort study of patients with lung cancer referred to Medical Oncology at our institution, during 4 years (2010-2013) and follow-up until April 2015. Inclusion criteria were age (80 years or older) and lung cancer diagnosis. The cohort was 41 patients
Results:
Our octogenarian patients were a 6.1% of our 672 patients seen in 2010-2013 interval. Of our 41 patients, 78% were male, and the median age is 81 years (80-87). Histologies are 88% NSCLC and 12% SCLC; in the NSCLC group, squamous carcinomas are most common (50%), followed by adenocarcinoma (26.8%). 51% patients were diagnosed in stages I-III, but only 3 patients were under radical treatment (2 surgery, 1 radiation therapy). 34% patients did not receive any oncologic treatment, only palliative care. Of the patients with active cancer treatment, 92% received first-line therapy. In the first-line group, 68% were under chemotherapy, 48% platinum doublet (more used schedules were carboplatin-vinorelbine, carboplatin-pemetrexed and carboplatin-paclitaxel), and 20% monotherapy (vinorelbine, pemetrexed and carboplatin) and 24% TKi (all EGFR mutated, with gefitinib and erlotinib). 26.8% (11) of patients received second-line treatment (10 erlotinib and 1 pemetrexed), and only 2 patients received 3 or more lines (1 patient up to 7 lines). 39 of 41 patients died (95%), and most patients die at home (95%). The median survival time is 11.19 months (CI 95% 7.84-14.53) and median overall survival is 8 months (CI 95% 4.51-11.48). In male patients, median survival time expected is 9.97 months, and in female patients, 14.88 months. Depending on the stage, stage IV patients had a expected survival of 9.94 months and stage I-III patients, 11.40 months, with no statistically significant diference. Depending on smoking status, survival is 8.95 months for ever-smokers, and 18.44 months for never-smokers (p-value: 0.035). Depending on therapy, survival in active cancer treatment group is 14.56 months, and in palliative care only group is 5.28 months (p-value: 0.001)
Conclusion:
In our cohort of elderly patients, with a small number of patients (a 6% of all the patients, maybe underreferred), we found some differences with our global lung cancer patients group. The ratio SCLC-NSCLC is quite similar (12-88% in elderly vs 14-86% in all our patients), but there is a different pattern according histological subtypes, with more squamous carcinomas in this cohort (44% vs 29.6%), and more EGFR mutations (24% vs 18%). We see that survival was better in patients receiving active cancer treatment plus best supportive care vs only palliative care. Factors influencing survival are smoking status (ever vs never-smokers) and sex. Although is essential a joint management with Palliative Care, in this particular group of patients, that are believed that cancer treatment is less useful, active cancer treatment is beneficial, if we always individualize decisions in each patient.
