Patients 65 years and older with lung cancer are living longer after surgery. The proportion of older people diagnosed with lung cancer is rapidly increasing, making this improved survival particularly significant.1
Results from this study showed that 5-year survival for older patients after surgery for lung cancer is favorable. Based on these results, surgeons might be better equipped to individualize care for this older population.
In this study, published in the Annals of Thoracic Surgery, researchers combined data from patients with lung cancer from The Society of Thoracic Surgeons (STS) General Thoracic Surgery Database (GTSD) with claims from the Centers for Medicare and Medicaid Services (CMS).
“The new data linkage between STS and CMS provides a more complete picture of what happens to a large subset of patients beyond the 30 days represented in the STS National Database,” said Felix Fernandez, MD, associate professor, Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, and first author of the study.
“We now know more about long-term survival after our interventions, which is important to patients. This information can be included in the shared decision-making process when discussing treatment options with patients.”
Data from GTSD included 37 009 records for patients 65 years and older who underwent surgery for lung cancer between 2002 and 2012. Merging this data with data from CMS resulted in successful linkage of records from 26 055 patients. This linkage provided long-term patient outcomes, including hospital re-admission rates, rates of second procedures, and long-term survival.
Five-year survival of all patients with lung cancer in the United States is approximately 17%, according to the National Cancer Institute. Less than half of all patients who undergo surgery for lung cancer survive to 5 years.
These results revealed a median survival in patients who underwent surgery for stage I disease of 6.7 years. In addition, 5-year survival for older patients with advanced lung disease who underwent surgery was 29.9% for stage III disease and 26.7% for stage IV disease.
“This greater-than-expected survival in older patients selected for operative therapy is noteworthy, especially considering that the prevalence of lung cancer is expected to increase as the population continues to grow older and more people survive into old age,” said Fernandez.
The results from the STS-CMS linked data on long-term patient outcome could be important in guiding clinical decisions in older patients.
“This research effort is important because it will assist in recommending effective, optimal treatments tailored specifically to older patients with lung cancer. And it is available during a time when we expect to be seeing more of these patients,” concluded Fernandez.
1. Fernandez FG, Furnary AP, Kosinski AS. Longitudinal follow-up of lung cancer resection from the Society of Thoracic Surgeons General Thoracic Surgery Database in patients 65 years and older [published online ahead of print April 28, 2016]. Ann Thorac Surg. doi:10.1016/j.athoracsur.2016.03.034