Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2018 Aug 3;18(1):127.
doi: 10.1186/s12890-018-0699-0.

Real-world treatment patterns for patients 80 years and older with early lung cancer: a nationwide claims study

Kyungjong Lee  1 , Hye Ok Kim  2 , Hee Kyoung Choi  2 , Gi Hyeon Seo  3
Affiliations
Comparative Study

Real-world treatment patterns for patients 80 years and older with early lung cancer: a nationwide claims study

Kyungjong Lee et al. BMC Pulm Med. .

Abstract

Background: Old age is an important factor that could affect the treatment of early-stage lung cancer. In this study, we evaluated the treatment patterns and outcomes of patients over the age of 80 years who had been diagnosed with early-stage lung cancer in real-world practice.

Methods: Elderly patients who were diagnosed with early-stage lung cancer between 2008 and 2016 were identified using claims data provided by the Health Insurance Review and Assessment Service. The proportion of patients who underwent surgical resection or stereotactic body radiation therapy (SBRT), practice pattern trends, and overall survival (OS) were analyzed from the population-based data.

Results: Over 9 years, 1,684 patients underwent surgical resection (74.9%) or SBRT (25.1%) as a localized treatment. From 2008 to 2016, the treatment modality changed: the percentage of patients who underwent surgical resection decreased from 90.6 to 71.4%, and those who underwent SBRT increased from 9.4 to 28.6%. The percentage of patients treated with SBRT increased over time (p < 0.001). The median OS was 56.4 months in the surgery group and 35.5 months in the SBRT group. The SBRT group showed worse OS compared with the surgery group (Adjusted hazard ratio, 1.44; 95% confidence interval, 1.21-1.72; p < 0.001).

Conclusion: Changes in local treatment patterns in elderly lung cancer patients were observed and SBRT increased its role in this population. Surgical resection or SBRT should be considered the treatment of choice in elderly patients with localized lung cancer. Further prospective studies are required to elucidate the benefits of surgery and SBRT.

Keywords: Lung neoplasms; Radiosurgery; Thoracic surgery; Treatment trends.

PubMed Disclaimer

Conflict of interest statement

This study obtained approval (Approval no. 2018-02-023) from the Samsung Medical Center institutional review board at Sungkyunkwan University School of Medicine to publish information obtained from public database. Informed consent from patients was waived by the Board.

Not applicable.

The authors declare that they have no competing interests.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Practice changes in local treatment patterns in very elderly (≥80 years old) patients diagnosed with early-stage lung cancer. The proportion of patients who underwent stereotactic body radiation therapy (SBRT) increased gradually as a local treatment modality in the old age group over the year (p < 0.001)
Fig. 2
Fig. 2
Kaplan-Meier curves for overall survival according to treatment modality in very elderly (≥80 years) patients with early-stage lung cancer (p < 0.001, log-rank test). SBRT, stereotactic body radiation therapy
See this image and copyright information in PMC

References

    1. Jung KW, Won YJ, Oh CM, Kong HJ, Lee DH, Lee KH. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2014. Cancer Res Treat. 2017;49(2):292–305. doi: 10.4143/crt.2017.118. - DOI - PMC - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67(1):7–30. doi: 10.3322/caac.21387. - DOI - PubMed
    1. Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009;27(17):2758–2765. doi: 10.1200/JCO.2008.20.8983. - DOI - PubMed
    1. Okami J, Higashiyama M, Asamura H, Goya T, Koshiishi Y, Sohara Y, et al. Pulmonary resection in patients aged 80 years or over with clinical stage I non-small cell lung cancer: prognostic factors for overall survival and risk factors for postoperative complications. J Thorac Oncol. 2009;4(10):1247–1253. doi: 10.1097/JTO.0b013e3181ae285d. - DOI - PubMed
    1. Berry MF, Onaitis MW, Tong BC, Harpole DH, D'Amico TA. A model for morbidity after lung resection in octogenarians. Eur J Cardiothorac Surg. 2011;39(6):989–994. doi: 10.1016/j.ejcts.2010.09.038. - DOI - PMC - PubMed

Publication types

LinkOut - more resources