Top

Surgery Today

Published in:

01-09-2014 | Original Article

Treatment of the postoperative recurrence of lung cancer in octogenarians

Authors: Manabu Yasuda, Akira Nagashima, Akira Haro, Genkichi Saitoh

Published in: Surgery Today | Issue 9/2014

Abstract

Purpose

Guidelines for the treatment of postoperative recurrent lung cancer in octogenarians do not exist. In this study, we investigated the prognosis of patients with recurrence after the resection of lung cancer and discuss the management of recurrent tumors in octogenarians.

Methods

This study clinicopathologically evaluated 135 octogenarians who underwent resections for lung cancer at a single institution between 1992 and 2010. We retrospectively reviewed the clinical records of 37 patients with confirmed recurrence. The overall survival of the patients and the treatments used for postoperative recurrence were evaluated.

Results

Among 37 patients, six underwent intensive treatment, 14 underwent palliative treatment and 17 received supportive care only. The overall survival rates of the patients in the antitumor treatment groups tended to be associated with a better prognoses than those of the patients in the supportive care only group, but they did not exhibit significantly better prognoses at 1 year (p = 0.202). However, among the patients with a good performance status, the intensive treatment group tended to exhibit prolonged survival. Of the 37 patients with recurrent tumors, five (14 %) died of other diseases.

Conclusions

Antitumor treatment of postoperative recurrent lung cancer in octogenarians may not always improve the survival rate. However, carefully selecting patients for intensive therapy, such as those with a good performance status, may lead to longer survival rates after postoperative recurrence in octogenarians.

Owonikoko TK, Ragin CC, Belani CP, Oton AB, Gooding WE, Taioli E, et al. Lung cancer in elderly patients: an analysis of the surveillance, epidemiology, and end results database. J Clin Oncol. 2007;25:5570–7.PubMedCrossRef

Brokx HA, Visser O, Postmus PE, Paul MA. Surgical treatment for octogenarians with lung cancer: results from a population-based series of 124 patients. J Thorac Oncol. 2007;2:1013–7.PubMedCrossRef

Osaki T, Shirakusa T, Kodate M, Nakanishi R, Mitsudomi T, Ueda H. Surgical treatment of lung cancer in the octogenarian. Ann Thorac Surg. 1994;57:188–92.PubMedCrossRef

Hanagiri T, Muranaka H, Hashimoto M, Nagashima A, Yasumoto K. Results of surgical treatment of lung cancer in octogenarians. Lung Cancer. 1999;23:129–33.PubMedCrossRef

Dominguez-Ventura A, Allen MS, Cassivi SD, Nichols FC 3rd, Deschamps C, Pairolero PC. Lung cancer in octogenarians: factors affecting morbidity and mortality after pulmonary resection. Ann Thorac Surg. 2006;82:1175–9.PubMedCrossRef

Finlayson E, Fan Z, Birkmeyer JD. Outcomes in octogenarians undergoing high-risk cancer operation: a national study. J Am Coll Surg. 2007;205:729–34.PubMedCrossRef

Endoh H, Yamamoto R, Satoh Y, Kuwano H, Nishizawa N. Risk analysis of pulmonary resection for elderly patients with lung cancer. Surg Today. 2013;43:514–20.PubMedCrossRef

The Japan Lung Cancer Society. General rule for clinical and pathological record of lung cancer. 7th ed. Chiba: The Japan Lung Cancer Society; 2010.

Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–55.PubMedCrossRef

10.

Blanchard EM, Arnaoutakis K, Hesketh PJ. Lung cancer in octogenarians. J Thorac Oncol. 2010;5:909–16.PubMedCrossRef

11.

Socinski MA, Crowell R, Hensing TE, Langer CJ, Lilenbaum R, Sandler AB, et al. Treatment of non-small cell lung cancer, stage IV: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:277S–89S.PubMedCrossRef

12.

Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med. 2002;346:92–8.PubMedCrossRef

13.

Ramalingam SS, Dahlberg SE, Langer CJ, Gray R, Belani CP, Brahmer JR, et al. Outcomes for elderly, advanced-stage non small-cell lung cancer patients treated with bevacizumab in combination with carboplatin and paclitaxel: analysis of Eastern Cooperative Oncology Group Trial 4599. J Clin Oncol. 2008;26:60–5.PubMedCrossRef

14.

Altundag O, Stewart DJ, Fossella FV, Ayers GD, Wei W, Zhou X, et al. Many patients 80 years and older with advanced non-small cell lung cancer (NSCLC) can tolerate chemotherapy. J Thorac Oncol. 2007;2:141–6.PubMedCrossRef

15.

Hesketh PJ, Lilenbaum RC, Chansky K, Dowlati A, Graham P, Chapman RA, et al. Chemotherapy in patients > or = 80 with advanced non-small cell lung cancer: combined results from SWOG 0027 and LUN 6. J Thorac Oncol. 2007;2:494–8.PubMedCrossRef

16.

Chen YM, Perng RP, Chen MC, Tsai CM, Ming-Liu J, Whang-Peng J. A phase II trial of vinorelbine plus gemcitabine in previously untreated inoperable (stage IIIb/IV) non-small-cell lung cancer patients aged 80 or older. Lung Cancer. 2003;40:221–6.PubMedCrossRef

17.

NSCLC Meta-Analyses Collaborative Group. Chemotherapy in addition to supportive care improves survival in advanced non-small-cell lung cancer: a systematic review and meta-analysis of individual patient data from 16 randomized controlled trials. J Clin Oncol. 2008;26:4617–25.PubMedCentralCrossRef

18.

Scagliotti GV, Parikh P, von Pawel J, Biesma B, Vansteenkiste J, Manegold C, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol. 2008;26:3543–51.PubMedCrossRef

19.

Chen KY, Chen JH, Shih JY, Yang CH, Yu CJ, Yang PC. Octogenarians with advanced non-small cell lung cancer: treatment modalities, survival, and prognostic factors. J Thorac Oncol. 2010;5:82–9.PubMedCrossRef

20.

Jackman DM, Yeap BY, Lindeman NI, Fidias P, Rabin MS, Temel J, et al. Phase II clinical trial of chemotherapy-naive patients > or = 70 years of age treated with erlotinib for advanced non-small-cell lung cancer. J Clin Oncol. 2007;25:760–6.PubMedCrossRef

21.

Ebi N, Semba H, Tokunaga SJ, Takayama K, Wataya H, Kuraki T, et al. A phase II trial of gefitinib monotherapy in chemotherapy-naïve patients of 75 years or older with advanced non-small cell lung cancer. J Thorac Oncol. 2008;3:1166–71.PubMedCrossRef

22.

Turner NJ, Muers MF, Haward RA, Mulley GP. Do elderly people with lung cancer benefit from palliative radiotherapy? Lung Cancer. 2005;49:193–202.PubMedCrossRef

23.

LeCaer H, Barlesi F, Corre R, Jullian H, Bota S, Falchero L, et al. A multicentre phase II randomised trial of weekly docetaxel/gemcitabine followed by erlotinib on progression, vs the reverse sequence, in elderly patients with advanced non small-cell lung cancer selected with a comprehensive geriatric assessment (the GFPC 0504 study). Br J Cancer. 2011;105:1123–30.PubMedCentralPubMedCrossRef

24.

Caillet P, Canoui-Poitrine F, Vouriot J, Berle M, Reinald N, Krypciak S, et al. Comprehensive geriatric assessment in the decision-making process in elderly patients with cancer: ELCAPA study. J Clin Oncol. 2011;29:3636–42.PubMedCrossRef

25.

Maas HA, Janssen-Heijnen ML, Olde Rikkert MG, Machteld Wymenga AN. Comprehensive geriatric assessment and its clinical impact in oncology. Eur J Cancer. 2007;43:2161–9.PubMedCrossRef

26.

Biesma B, Wymenga AN, Vincent A, Dalesio O, Smit HJ, Stigt JA, et al. Quality of life, geriatric assessment and survival in elderly patients with non-small-cell lung cancer treated with carboplatin-gemcitabine or carboplatin-paclitaxel: NVALT-3 a phase III study. Ann Oncol. 2011;22:1520–7.PubMedCrossRef

27.

Extermann M, Aapro M, Bernabei R, Cohen HJ, Droz JP, Lichtman S, et al. Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol. 2005;55:241–52.PubMedCrossRef

Title: Treatment of the postoperative recurrence of lung cancer in octogenarians
Authors: Manabu Yasuda
Akira Nagashima
Akira Haro
Genkichi Saitoh
Publication date: 01-09-2014
Publisher: Springer Japan
Published in: Surgery Today / Issue 9/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-013-0719-x

At a glance: The STEP trials

Springer Medicine

Treatment of the postoperative recurrence of lung cancer in octogenarians

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2014

Hemorrhage from the pancreatic cut end into the jejunum after binding pancreaticojejunostomy: report of a case

Early postoperative results for females undergoing isolated coronary artery bypass surgery: comparison of the pre- and postmenopausal periods

Cystic adventitial disease of the popliteal artery: report of two cases

A treatment strategy for preventing pouchitis as a postoperative complication of ulcerative colitis: the significance of the management of cuffitis

Surgical management of a primary external iliac venous aneurysm causing pulmonary thromboembolism: report of a case

Prognostic factors for peritoneal carcinomatosis originating from colorectal cancer: an analysis of 921 patients from a multi-institutional database