Background: Up to 40% newly diagnosed non-small cell lung cancer (NSCLC) patients are ≥70 years, with comorbidities which affect standard treatment deliver necessity Chemotherapy planning remains a challenge, based on risk-benefit ratio.
Aim: To record the epidemiological, clinical, laboratory data & outcome in the 160 pts [95 (59%) men, 65 (41%) women], with NSCLC ≥70 years, median age 75 [70-86] y, stage IIIB+IV, consecutively admitted in our Unit, between January 2007 to June 2014.
Methods and results: All documented 84 pts (52.5%, 70-75 y, group A), “young-elderly” & 76 (47.5%, 76-86 y, group B), “elderly-elderly”. Median ECOG 2 (0-3). Active or ex-smokers were 152 (95%), passive 8 (5%). Presentation symptoms: haemoptysis 59 (37%) total, 38 (45%) & 21 (28%) respectively, cough 46 (29%), 29 (35%) & 17 (22%) dyspnoea in 16 (10%), 7 (8%) & 9 (12%), chest discomfort in 9 (6%) L, 4 (5%) & 5 (7%), cervical lymphadenopathy in 13 (8%), 3 (4%) & 10 (13%), SVC in 12 (7.5%), 3 (4%) & 9 (12%), Pancoast 5 (3%) IIIB NSCLC, 3 (4%) & 2 (3%) respectively. Paraneoplastic: neuromyopathy, hypercalcemia, phlebitis, diabetes, SIADH in 1, 2, 1, 1 & 8 (5%) respectively. Adenoca 69(43%), SCC 49 (31%), large cell 8 (5%), adenoSC 16 (10%) & neuroendocrine 18 (11%). SCC & adenoSCC had 29 (35%) & 35 (46%), in A/B. Osteoarthropathy found in 61 (38%) pts, 33 (48%) adenoca vs. 28 (31%) with non. Stage IV 142 pts, metastatic in liver, bones, adrenal, lung, brain, 106 (75%), 88 (62%), 56 (39%), 42 (30%), 28 (20%).
Comorbidities: Hypertension: 138 (86%), A/B: 68/73; COBD: 130 (81%), A/B: 66/64; DIABETES: 122 (76%), A/B: 56/66; Ischemic heart failure in 114 (71%), A/B: 54/60; Dyslipidemia: 86 (54%), A/B: 39/47; Low bone density: 71 (41%), A/B: 31/40; Hypothyroidism: 36 (22.5%), A/B: 20/16; Parkinson: 17 (11%), A/B: 9/8 ; ≥3 comorbidities had 36/84 (43%) & 41/76 (54%) pts of A/B; Elevated LDH in 131(81%), A/B: 67/64. Median creatinine: 1.5 mg/dL; A/B: 1.5 (1.1-1.9)/1.5 (0.9-2) mg/dL.
Conclusions: Elderly NSCLC pts: 1. Prior therapeutic decision evaluation of PS/comorbidities is hallmark; 2. Evaluation of medical comorbidities is crucial prior any therapeutic design.
