Stefano Bongiolatti1, Francesca Mazzoni2, Alessandro Gonfiotti1, Giulia Di Pierro2, Alberto Salvicchi3, Sara Borgianni1, Katia Ferrari4, Luca Voltolini1. 1. Thoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy. 2. Medical Oncology Unit, Careggi University Hospital, Florence, Italy. 3. Thoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy. alberto.salvicchi@libero.it. 4. Respiratory Medicine, Careggi University Hospital, Florence, Italy.
Abstract
OBJECTIVE: Multimodality treatments are effective for locally advanced non-small cell lung cancer (LA-NSCLC) showing benefits in overall (OS) and disease-free survival (DFS), but these options are frequently denied to elderly patients. METHODS: The objectives of this retrospective study were: to investigate mortality, morbidity and oncological outcomes of pulmonary resection after induction therapy (IT) for NSCLC in elderly patients. We divided the cohort into two: patients < 70 years (group A) and patients ≥70 years (group B). A multivariable logistic regression was built to identify factors associated with morbidity. RESULTS: 77 patients underwent pulmonary resection after IT, 27 were aged ≥70 years. Type of chemotherapy, surgical procedures, pathological stages were comparable between the two groups, while the preoperative use of chemo-radiation therapy regimen was more frequent in group A (p = 0.027). In-hospital mortality was similar, while the percentage of patients with complications (38% vs 48.1%, p = 0.47) and the complication rate (50% vs 77%, p = 0.01) were higher in group B, but the severity of complications was comparable. The multivariable analysis did not identify any risk factors associated with morbidity. OS at 3 years and DFS at 2 years were not different (61% vs 48.5%, p = 0.64; 61.7% vs 44%, p = 0.393). CONCLUSIONS: Lung resection for LA-NSCLC after IT can be performed safely in selected elderly patients with favourable postoperative and mid-term oncological results.
OBJECTIVE: Multimodality treatments are effective for locally advanced non-small cell lung cancer (LA-NSCLC) showing benefits in overall (OS) and disease-free survival (DFS), but these options are frequently denied to elderly patients. METHODS: The objectives of this retrospective study were: to investigate mortality, morbidity and oncological outcomes of pulmonary resection after induction therapy (IT) for NSCLC in elderly patients. We divided the cohort into two: patients < 70 years (group A) and patients ≥70 years (group B). A multivariable logistic regression was built to identify factors associated with morbidity. RESULTS: 77 patients underwent pulmonary resection after IT, 27 were aged ≥70 years. Type of chemotherapy, surgical procedures, pathological stages were comparable between the two groups, while the preoperative use of chemo-radiation therapy regimen was more frequent in group A (p = 0.027). In-hospital mortality was similar, while the percentage of patients with complications (38% vs 48.1%, p = 0.47) and the complication rate (50% vs 77%, p = 0.01) were higher in group B, but the severity of complications was comparable. The multivariable analysis did not identify any risk factors associated with morbidity. OS at 3 years and DFS at 2 years were not different (61% vs 48.5%, p = 0.64; 61.7% vs 44%, p = 0.393). CONCLUSIONS: Lung resection for LA-NSCLC after IT can be performed safely in selected elderly patients with favourable postoperative and mid-term oncological results.