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
. 2022 Jul 28:9:972014.
doi: 10.3389/fsurg.2022.972014. eCollection 2022.

Identifying octogenarians with non-small cell lung cancer who could benefit from surgery: A population-based predictive model

Ce Chao  1 , Dongmei Di  1 , Min Wang  1 , Yang Liu  1 , Bin Wang  1 , Yongxiang Qian  1
Affiliations

Identifying octogenarians with non-small cell lung cancer who could benefit from surgery: A population-based predictive model

Ce Chao et al. Front Surg. .

Abstract

Background: As the population ages, there will be an increasing number of octogenarian patients with non-small cell lung cancer (NSCLC). In carefully selected elderly patients, surgery can improve long-term survival. To identify candidates who would benefit from surgery, we performed this study and built a predictive model.

Materials and methods: Data from NSCLC patients over 80 years old were obtained from the Surveillance, Epidemiology and End Results database. A 1:1 propensity score matching was performed to balance the clinicopathological features between the surgery and non-surgery groups. Kaplan-Meier analyses and log-rank tests were used to assess the significance of surgery to outcome, and Cox proportional-hazards regression and competing risk model were conducted to determine the independent prognostic factors for these patients. A nomogram was built using multivariable logistic analyses to predict candidates for surgery based on preoperative factors.

Results: The final study population of 31,462 patients were divided into surgery and non-surgery groups. The median cancer-specific survival time respectively was 53 vs. 13 months. The patients' age, sex, race, Tumor, Node, Metastasis score, stage, chemotherapy use, tumor histology and nuclear grade were independent prognostic factors. Apart from race and chemotherapy, other variates were included in the predictive model to distinguish the optimal surgical octogenarian candidates with NSCLC. Internal and external validation confirmed the efficacy of this model.

Conclusion: Surgery improved the survival time of octogenarian NSCLC patients. A novel nomogram was built to help clinicians make the decision to perform surgery on elderly patients with NSCLC.

Keywords: NSCLC; Octogenarians; SEER; nomogram; surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The flowchart of determining final study population.
Figure 2
Figure 2
Kaplan-Meier curves of elderly patients with non-small cell lung cancer between surgery and non-surgery groups before and after PSM. (A,B) Kaplan-Meier curve comparing OS (A) and CSS (B) before PSM. (C,D): Kaplan-Meier curve comparing OS (C) and CSS (D) after PSM. Abbreviations: CSS, cancer-special survival; OS, overall survival; PSM, propensity score matching.
Figure 3
Figure 3
A nomogram to determining surgical beneficial population in elderly patients with non-small cell lung cancer.
Figure 4
Figure 4
The ROC curve (A,B), calibration plots (C,D), decision curve analysis curve (E,F) of nomogram in training and testing set.
Figure 5
Figure 5
Kaplan–Meier curve to compare differential beneficial groups in the population after PSM based on this nomogram. Abbreviations: PSM, propensity score matching; LCSS, lung cancer-special survival.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bade BC, Dela Cruz CS. Lung cancer 2020: epidemiology, etiology, and prevention. Clin Chest Med. (2020) 41:1–24. 10.1016/j.ccm.2019.10.001 - DOI - PubMed
    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. (2021) 71:209–49. 10.3322/caac.21660 - DOI - PubMed
    1. Saftic I, Bille A, Asemota N, Berjon de la Vega L, Routledge T, King J, et al. Risks and rewards of the surgical treatment of lung cancer in octogenarians. Interact Cardiovasc Thorac Surg. (2021) 33:905–12. 10.1093/icvts/ivab194 - DOI - PMC - PubMed
    1. Pilleron S, Soto-Perez-de-Celis E, Vignat J, Ferlay J, Soerjomataram I, Bray F, et al. Estimated global cancer incidence in the oldest adults in 2018 and projections to 2050. Int J Cancer. (2021) 148:601–8. 10.1002/ijc.33232 - DOI - PMC - PubMed
    1. Blanco R, Maestu I, de la Torre MG, Cassinello A, Nunez I. A review of the management of elderly patients with non-small-cell lung cancer. Ann Oncol. (2015) 26:451–63. 10.1093/annonc/mdu268 - DOI - PubMed