Prognosis and survival of lung cancer in the elderly

  • Authors

    • Souad Souilah
    • Nassima Djami Pulmonology Department, Bab El Oued University Hospital, Algiers, Algeria Benyoucef Benkhedda University
    2024-03-06
    https://doi.org/10.14419/m01nz878

  • Introduction: In our department, from 2012 to 2020, 33.3% of patients treated for lung cancer were over 70 years old. Our study aimed to estimate overall survival and investigate the significance of prognostic factors in a population of 308 patients aged over 70 with lung cancer, collected from January 2012 to June 2020.

    Methods: The initial assessment included at least a bronchoscopic examination and thoracic computed tomography. Survival rates were calculated using the Kaplan-Meier method and presented with 95% confidence intervals. The Log-Rank test was utilized for the comparison of survival curves.

    Results: The 308 cases (9.6% females, 90.4% males) included 92.2% NSCLC (49.6% squamous cell, 45.4% adenocarcinomas) and 7.8% SCLC. The median age at diagnosis was 74 years, 14.6% were non-smokers, and 55.8% were former smokers. 67.9% of patients had at least one comorbidity, 1.6% had a PS equal to 0, and 28.2% had a PS ≥ 2. TNM staging found 9.2% of cases at stages I and II; 31.2% at stage III, and 59.7% at stage IV. The median overall survival was 8.312 months [6.947-9.678], and the 1-year survival rate was 35.1%. Better survival was correlated with female gender, absence of smoking, PS ≤ 1, and TNM staging.

    Conclusion: All standard therapeutic options for bronchial cancer can be considered in the elderly, but physiological aging and the prevalence of comorbidities alter the risk-benefit ratio of treatments. This emphasizes the need for the implementation of a comprehensive management strategy for this segment of society.

    Author Biographies

    • Souad Souilah

      Doctor

      Pulmonology Department, Bab El Oued University Hospital, Algiers, Algeria

      Benyoucef Benkhedda University.

      Non-Communicable Respiratory Diseases Laboratory

    • Nassima Djami, Pulmonology Department, Bab El Oued University Hospital, Algiers, Algeria Benyoucef Benkhedda University

      Doctor

      Pulmonology Department, Bab El Oued University Hospital, Algiers, Algeria

      Benyoucef Benkhedda University.

      Non-Communicable Respiratory Diseases Laboratory

  • References

    1. J. Ferlay, M. Colombet, I. Soerjomataram et al., “Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods,” Int J Cancer, vol. 144, no. 8, pp. 1941-1953, Apr 15, 2019. https://doi.org/10.1002/ijc.31937.
    2. D. Hammouda, M. YAHIAOUI, L. BOUTEKDJIRET et al., "REGISTRE DES TUMEURS D’ALGER- Année 2017," https://www.insp.dz/images/PDF/Les%20registres/TumeursAlger/Registre_tumeurs_Alger_2017.pdf, Institut National de Santé Pu-blique, Edition 2019, p. 33.
    3. M. Hamdi Cherif, Z. Zaidi, D. Abdellouche et al., “Registre du cancer de Sétif (Algérie): incidence, tendance et survie, 1986–2005,” Journal Africain du Cancer / African Journal of Cancer, vol. 2, no. 4, pp. 245-258, 2010/11/01, 2010. https://doi.org/10.1007/s12558-010-0075-3.
    4. R. L. Siegel, K. D. Miller, and A. Jemal, “Cancer statistics, 2019,” CA Cancer J Clin, vol. 69, no. 1, pp. 7-34, Jan 2019. https://doi.org/10.3322/caac.21551.
    5. J. Ferlay, M. Colombet, I. Soerjomataram et al., “Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018,” Eur J Cancer, vol. 103, pp. 356-387, Nov 2018. https://doi.org/10.1016/j.ejca.2018.07.005.
    6. E. Quoix, G. Zalcman, J. P. Oster et al., “Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in el-derly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial,” Lancet, vol. 378, no. 9796, pp. 1079-88, Sep 17, 2011. https://doi.org/10.1016/S0140-6736(11)60780-0.
    7. R. Pirker, J. R. Pereira, A. Szczesna et al., “Prognostic factors in patients with advanced non-small cell lung cancer: data from the phase III FLEX study,” Lung Cancer, vol. 77, no. 2, pp. 376-82, Aug 2012. https://doi.org/10.1016/j.lungcan.2012.03.010.
    8. T. Kawaguchi, M. Takada, A. Kubo et al., “Gender, histology, and time of diagnosis are important factors for prognosis: analysis of 1499 never-smokers with advanced non-small cell lung cancer in Japan,” J Thorac Oncol, vol. 5, no. 7, pp. 1011-7, Jul 2010. https://doi.org/10.1097/JTO.0b013e3181dc213e.
    9. Y. Kogure, M. Ando, H. Saka et al., “Histology and smoking status predict survival of patients with advanced non-small-cell lung can-cer. Results of West Japan Oncology Group (WJOG) Study 3906L,” J Thorac Oncol, vol. 8, no. 6, pp. 753-8, Jun 2013. https://doi.org/10.1097/JTO.0b013e31828b51f5.
    10. W. L. Read, R. M. Tierney, N. C. Page et al., “Differential prognostic impact of comorbidity,” J Clin Oncol, vol. 22, no. 15, pp. 3099-103, Aug 1, 2004. https://doi.org/10.1200/JCO.2004.08.040.
    11. J. P. Sculier, K. Chansky, J. J. Crowley et al., “The impact of additional prognostic factors on survival and their relationship with the anatomical extent of disease expressed by the 6th Edition of the TNM Classification of Malignant Tumors and the proposals for the 7th Edition,” J Thorac Oncol, vol. 3, no. 5, pp. 457-66, May 2008. https://doi.org/10.1097/JTO.0b013e31816de2b8.

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  • How to Cite

    Souilah, S., & Djami, N. (2024). Prognosis and survival of lung cancer in the elderly. International Journal of Medicine, 12(1), 17-19. https://doi.org/10.14419/m01nz878