Impact of Increasing Age on Cause-Specific Mortality and Morbidity in Patients With Stage I Non-Small-Cell Lung Cancer: A Competing Risks Analysis

被引：164

作者：

Eguchi, Takashi ^{[1
,2
]}

Bains, Sarina ^{[1
]}

Lee, Ming-Ching ^{[1
,3
]}

Tan, Kay See ^{[1
]}

Hristov, Boris ^{[1
]}

Buitrago, Daniel H. ^{[1
]}

Bains, Manjit S. ^{[1
]}

Downey, Robert J. ^{[1
]}

Huang, James ^{[1
]}

Isbell, James M. ^{[1
]}

Park, Bernard J. ^{[1
]}

Rusch, Valerie W. ^{[1
]}

Jones, David R. ^{[1
]}

Adusumilli, Prasad S. ^{[1
]}

机构：

[1] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA

[2] Shinshu Univ, Matsumoto, Nagano, Japan

[3] Natl Yang Ming Univ, Taipei, Taiwan

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2017年 / 35卷 / 03期

基金：

美国国家卫生研究院;

关键词：

OBSTRUCTIVE PULMONARY-DISEASE; LONG-TERM SURVIVAL; SURGICAL RESECTION; DIFFUSING-CAPACITY; SUBLOBAR RESECTION; LIMITED RESECTION; ELDERLY-PATIENTS; SCORING SYSTEM; CO-MORBIDITY; SURGERY;

D O I：

10.1200/JCO.2016.69.0834

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose To perform competing risks analysis and determine short-and long-term cancer-and noncancer-specific mortality and morbidity in patients who had undergone resection for stage I non-small-cell lung cancer (NSCLC). Patients and Methods Of 5,371 consecutive patients who had undergone curative-intent resection of primary lung cancer at our institution (2000 to 2011), 2,186 with pathologic stage I NSCLC were included in the analysis. All preoperative clinical variables known to affect outcomes were included in the analysis, specifically, Charlson comorbidity index, predicted postoperative (ppo) diffusing capacity of the lung for carbon monoxide, and ppo forced expiratory volume in 1 second. Cause-specific mortality analysis was performed with competing risks analysis. Results Of 2,186 patients, 1,532 (70.1%) were >= 65 years of age, including 638 (29.2%)>= 75 years of age. In patients, 65, 65 to 74, and >= 75 years of age, 5-year lung cancer-specific cumulative incidence of death (CID) was 7.5%, 10.7%, and 13.2%, respectively (overall, 10.4%); noncancer-specific CID was 1.8%, 4.9%, and 9.0%, respectively (overall, 5.3%). In patients >= 65 years of age, for up to 2.5 years after resection, noncancer-specific CID was higher than lung cancer-specific CID; the higher noncancer-specific, early-phase mortality was enhanced in patients >= 75 years of age than in those 65 to 74 years of age. Multivariable analysis showed that low ppo diffusing capacity of lung for carbon monoxide was an independent predictor of severe morbidity (P < .001), 1-year mortality (P < .001), and noncancer-specific mortality (P < .001), whereas low ppo forced expiratory volume in 1 second was an independent predictor of lung cancer-specific mortality (P = .002). Conclusion In patients who undergo curative-intent resection of stage I NSCLC, noncancer-specific mortality is a significant competing event, with an increasing impact as patient age increases. (C) 2016 by American Society of Clinical Oncology

引用

页码：281 / +

页数：12

共 48 条

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