Results and impact of routine assessment of comorbidity in elderly patients with non-small-cell lung cancer aged80 years
| Autor: | Fabrice Barlesi, Pascal Thomas, David P. Breen, Christophe Doddoli, Jean-Philippe Torre, Myriam Zemerli, Philippe Astoul |
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| Rok vydání: | 2007 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Cancer Research medicine.medical_specialty Lung Neoplasms Comorbidity Recurrence Internal medicine Carcinoma Non-Small-Cell Lung medicine Humans Stage (cooking) Prospective cohort study Lung cancer Aged 80 and over Performance status business.industry Hazard ratio medicine.disease Survival Analysis Confidence interval Surgery Clinical trial Oncology Female business |
| Zdroj: | Clinical lung cancer. 8(5) |
| ISSN: | 1525-7304 |
| Popis: | Elderly patients now represent a bigger proportion of patients with non-small-cell lung cancer (NSCLC). However, data from clinical trials are limited for this age group, and the elderly are often excluded from optimal treatment for several reasons, including comorbidity.We reviewed a 10-year experience on proven patients with NSCLC aged80 years; comorbidity was assessed using the Charlson Comorbidity index (CCI). The main objective was the impact of comorbidity on survival outcome.Of 109 managed patients aged80 years, 74 patients had a proven diagnosis of NSCLC. Performance status was2 in 58 patients and TNM classification of malignant tumors was I-II, IIIA-IIIB, and IV in 18, 27, and 29 patients, respectively. Comorbidity was present for 49 patients. Charlson Comorbidity Index ranged from 4 to 12 with 31 patients having a CCIor= 6. Sixteen patients received supportive care only, whereas 23 patients were operated on, 12 received radiation therapy, and 23 had chemotherapy. Eight grade 3/4 toxicities were reported (3 patients discontinued treatment). Multivariate analysis demonstrated a significant increase in the risk of death for patients with a poor Eastern Cooperative Oncology Group performance status (hazard ratio, 2.64; 95% confidence interval, 1.3-5.36; P = 0.007) and an advanced TNM stage (hazard ratio, 3.31; 95% confidence interval, 1.99-5.5; P0.00001). Although statistic significance was not reached, a difference in overall survival was shown between patients with a CCI6 and CCIor= 6 (12.2 months vs. 8.2 months; P = 0.08).These results support a role for the CCI as a routine means to assess comorbidity, because patients with fewer comorbidities tolerate and derive survival benefit of optimal NSCLC management. These findings must be confirmed in prospective studies. |
| Databáze: | OpenAIRE |
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