Survival and outcomes of surgical treatment of the elderly NSCLC in China: A retrospective matched cohort study

AimTo compare survival and outcomes of pulmonary resection for elderly NSCLC patients with that of younger controls in China.MethodsA database which included 4792 NSCLC patients who received complete surgery from 1985 to 2005 was used. The elderly patients (≥70) were matched 1:1 to controls (<70) by 5 variables: gender; stage; histology; pulmonary resection types; adjuvant chemotherapy. The long-term survival rates, the operative mortality and short-term death after surgery were compared.ResultsThere were 1304 patients: 652 cases were ≥70. The 5-year OS of elderly was 39%; that of the controls was 45% (p = 0.06). Operative mortality rate between elderly and the controls was similar (9/652 vs 4/652 p = 0.16) but the short-term death within 2 months after the surgeries were different (23/652 vs 7/652 p = 0.003). The elderly with lobectomy had a worse 5-year OS than controls (42% vs 46% p = 0.05), but the 5-year OS was similar for patients who received pneumonectomy (24% vs 36% p = 0.40) and the limited resections (46% vs 39% p = 0.27). The 5-year OS in patients who received adjuvant chemotherapy were similar (49% vs 44% p = 0.10).ConclusionElderly have the similar long-term OS with the controls. They should not be denied the curative surgery and adjuvant chemotherapy based on their chronologic age. However, elderly patients had a higher risk of short-term death after the surgery, which suggests that elderly be given more intensive care after the surgery.