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J. Okamoto
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P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.02-006 - How Should We Handle Elderly Patients of the Non-Small Cell Lung Cancer? (ID 2590)
09:30 - 09:30 | Author(s): J. Okamoto
- Abstract
Background:
In Japan, the ratio of lung cancer patients of octogenarian was still increasing in 2012. Elderly patients used to have comorbidities. Thus it is more difficult to select the surgical treatment of the elderly person in the lung cancer. Therefore, we aimed to clarify the preferred surgical management in this patient group.
Methods:
A retrospective study was conducted between April 2008 and March 2015 that included patients with non-small cell lung cancer (NSCLC) aged ≥75 years. Patients were divided into those who underwent partial resection and those who underwent lobectomy.
Results:
This study included 44 patients: 28 men and 16 women. We divided into two groups; one is partial resection (P-group) and another is lobectomy group (L-group). In patient’s characteristics, there were mostly no significant differences between two groups, without preoperative diabetes mellitus (p = 0.0271), tumor size on CT (p = 0.0002), operation time (p < 0.0001), post-operative hospital days (p = 0.0003), or pathological tumor size (p < 0.0001). In survival analysis, there were significant differences in overall survival (OS) between P-group and L-group (p = 0.0335). However, there was no significant difference in disease-free survival (DFS) rate among the two categories (p = 0.41), and in OS among stage I patients (p = 0.16). Postoperative complication caused poor prognosis (p = 0.0004). However, operation procedure did not correlate with postoperative morbidity. Cox regression analysis revealed statistical significance for the Brinkman Index(BI) (p = 0.0318), the ratio of the pulmonary artery diameter to the ascending aorta diameter (PA:A) (p = 0.0182), and the alveolar–arterial oxygen gradient (A-aDO2) (p = 0.0300). Only the PA:A ratio remained significant after multivariate analysis, with a higher ratio associated with better survival. Only the PA:A ratio remained significant after multivariate analysis, with a higher ratio associated with better survival, by Wilcoxon’s test (p = 0.0376).
Conclusion:
In elder patients with NSCLC, surgical resection should not be denied by only age. However, operation procedure should select Partial resection, compare to Lobectomy, as much as possible, especially, with the higher patients of PA: A ratio.
