Analysis of young and elderly advanced stage nonsmall-cell lung carcinoma cases

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.

The data of 370 advanced stage young (<65 years old) and elderly (>or=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.

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).

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.