KEY TAKEAWAYS
- The study aimed to compare NSCLC surgery outcomes and identify risk factors in older versus younger patients.
- Researchers suggested that age alone should not dictate surgical decisions; factors like health status are more critical.
Case series reports indicate that surgical outcomes for non-small cell lung cancer (NSCLC) may be similar across different age groups when surgery is performed with curative intent.
Seyer Safi and the team aimed to compare morbidity and mortality rates following NSCLC surgery between older patients (≥75 years) and younger patients (<75 years) and to identify independent predictive risk factors for these outcomes.
Researchers reviewed 2015 NSCLC patients who had curative surgery at a specialized center from January 2010 to December 2015. They conducted a matched-pair analysis comparing 227 older patients (≥75 years) with 227 younger patients (<75 years).
They evaluated short-term outcomes like postoperative complications, hospital stay, 30-day and 90-day mortality, and long-term outcomes, including disease-free and overall survival.
About 454 patients were included in the matched-pair analysis. Postoperative complications occurred in 36% of younger patients, compared to 42% in older patients (P = 0.163), indicating that age was not significantly associated with the occurrence of postoperative complications. The median length of hospital stay was 14 days for older patients and 13 days for younger patients (P = 0.185). The 90-day mortality rate was 2.2% for younger patients and 4% for older patients (P = 0.424).
In patients aged 75 and older, impaired performance status (ECOG ≥ 1) was associated with decreased overall survival (HR = 2.15, CI 1.34-3.46), as were preoperative serum C-reactive protein/albumin ratio ≥ 0.3 (HR = 1.95, CI 1.23-3.11) and elevated preoperative serum creatinine levels ≥ 1.1 mg/dl (HR = 1.84, CI 1.15-2.95). In the younger cohort, male sex (HR = 2.26, CI 1.17-4.36), postoperative stage III disease (HR = 4.61, CI 2.23-9.54), and preoperative anemia (hemoglobin < 12 g/dl) (HR = 2.09, CI 1.10-3.96) were associated with decreased overall survival.
The study concluded that lung resection for NSCLC in older patients yields postoperative outcomes similar to those in younger patients. In older individuals, factors such as physical activity, comorbidities, and nutritional status should guide surgical decisions rather than age alone.
The study received open-access funding from Projekt DEAL.
Source: https://pubmed.ncbi.nlm.nih.gov/39118130/
Safi S, Gysan MR, Weber D, et al. (2024). “Peri- and postoperative morbidity and mortality in older patients with non-small cell lung cancer: a matched-pair study.” World J Surg Oncol. 2024 Aug 8;22(1):213. doi: 10.1186/s12957-024-03491-6. PMID: 39118130.
