Elderly lung cancer patients in good physical condition do as well after surgery as younger patients, according to a study published in the journal Chest.

Lung cancer remains the leading cause of cancer-related deaths in the US. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for approximately 75-80% of all lung cancers. It is named for the type of cell in which the cancer originated. Standard treatment for NSCLC largely depends upon the stage or extent of spread of the cancer; options may include surgery, chemotherapy, radiation therapy, and/or targeted therapy.

Researchers have reported that, for some types of cancer, the very elderly are less likely than younger patients to be treated with surgery or combined chemotherapy. There is possible concern that the very elderly will be less likely to tolerate these treatments. However, avoiding these therapies may result in less effective cancer treatment among older patients. It is therefore important to determine whether or not treatment decisions should be based on age.

To evaluate how survival after surgery varies by age, researchers in Japan studied 1114 patients who were treated for NSCLC between 1993 and 2002. Patients were divided into two age groups: 75 years or younger and over 75. The older patients were more likely than the younger patients to have other serious health problems or a poor level of functioning. They were also less likely to be treated with surgery: 36% of the older patients were treated with surgery, compared to 51% of the younger patients. Among patients who had surgery, risk of death around the time of surgery and overall survival were similar for the two age groups.

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The researchers conclude that older patients are more likely than younger patients to have health problems that prevent them from having surgery. However, elderly patients who are in good physical condition do as well after surgery as younger patients. Decisions about surgery should not be based on age alone.

Reference: Sawada S, Komori E, Nogami N et al. Advanced age is not correlated with either short-term or long-term postoperative results in lung cancer patients in good clinical condition. Chest. 2005;128:1557-1563.

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