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

Aim To compare survival and outcomes of pulmonary resection for elderly NSCLC patients with that of younger controls in China. Methods A 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. Results There 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). Conclusion Elderly 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.