Surgical results of stage I non-small cell lung cancer: comparison between elderly and younger patients

The aim of this study was to evaluate the overall cancer-related survival in younger and elderly (over 70 years old) patients with stage I non-small cell lung cancer (NSCLC) together with prognostic factors in the elderly.

The patient records of 797 patients who underwent surgery for stage I NSCLC were analyzed retrospectively. A total of 132 patients were over 70 years old. The clinical variables and overall cancer-related survival were compared between two groups. An analysis was performed to determine the risk factors that influenced the survival of elderly patients. Variables analyzed included sex, presence of symptoms, operative procedure, histopathology, size of tumor and tumor classification.

Between the two groups, the nature of the operation performed (pneumonectomy or not) and the presence of symptoms reached statistical significance (P<0.001). Overall 5- and 10-year survival rates were 64.5% and 53.68% in younger patients and 58.23% and 52.24% in the elderly. There was no significant difference in survival between the groups (P=0.35). The only significant prognostic factor in the elderly patients was the size of the tumor in the multivariate analysis (P=0.0442, relative risk 2.28 (1.02-5.10 95% CI)).

Surgical resection for stage I NSCLC in elderly patients over the age of 70 years results in a comparable overall cancer-related survival to that evident in younger patients. The size of the tumor is the only significant factor to influence the survival of elderly patients. Continued careful selection of elderly patients for surgical resection is important for acceptable operative results.