SEER and Medicare databases analysis of outcomes after surgical management of early-stage lung cancer in octogenarians

As the population ages more octogenarians are undergoing surgical resection for early-stage lung cancer. Analysis of SEER and Medicare databases investigated age-related risks associated with surgical management for stage IA non-small cell lung cancer (NSCLC). One-year all cause mortality among octogenarians after surgery for NSCLC was more than double that of the group aged 65 to 69 years (15.2% versus 7.3%; p<0.001). In adjusted analysis, octogenarians had a 62% greater one-year mortality compared with those younger than 80 years (RR 1.62; 95% CI 1.48-1.78). Risk of death within 5 years was 52% higher among octogenarians (HR 1.52: 95% CI 1.42-1.62). Additional factors associated with one-year mortality included male sex, higher comorbidity burden, lower county median income, open approach, and sub-lobar resection. The authors conclude that these data highlight the need for further research and the development of interventions to improve surgical outcomes in older NSCLC patients.