Treatment results of non-small cell lung cancer in octogenerians

Objective: In order to establish the treatment of non-small cell lung cancer in octogenarians we retrospectively reviewed our experiences. Patients: The present study included 109 patients with a mean age of 82 ranging from 80 to 94, who were treated at our institute from 1972 through 1996. There were 74 men and 35 women. Sixty-one patients had adenocarcinoma, 35 had squamous cell carcinoma and 13 had other histological types. Thirty patients had clinical stage I disease, 13 had stage II, 22 had stage IIIA, 12 had stage IIIB and 32 had stage IV. Results: In clinical stage I, 18 patients (58.1%) underwent an operation with a 5 year-survival rate of 48.6%, including two operation-related deaths. On the other hand, no patients survived 5 years after either radiation treatment (6 patients) or other treatment (6 patients). In clinical stage III, only 3 patients underwent surgical resection. Twenty patients received radiotherapy with (2 patients) or without (18 patients) chemotherapy. There were 5 treatment-related deaths (25%). Concerning other patients, 3 received chemotherapy, 2 received pleural drainage, and 6 had no other treatment. There was no significant difference in survival between the radiotherapy group and the other treatment group (MST 8M : 20M, p=0.36). In clinical stage IV, there was no significant difference in survival between the treatment group (systemic chemotherapy, radiotherapy, etc.; n = 19) and the non-treatment group (n=13). Conclusion: In clinical stage I, surgical resection is considered to be the treatment of choice while the best supportive care is so in the advanced stages.