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Eur J Cardiothorac Surg 2005;28:911-912
© 2005 Elsevier Science NL

Letter to the Editor

Adjuvant chemotherapy in patients 80–89 years of age with non-small cell lung cancer

Ozden Altundag a , Mehmet Ates b , Mustafa A. Atik c , Kadri Altundag a , d , *

a 8181 Fannin Street No.728, Houston, TX 77054, USA
b Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Education and Research Hospital, Istanbul, Turkey
c Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
d Department of Medical Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey

Received 2 September 2005; accepted 13 September 2005.

* Tel.: +1 713 795 0438; fax: +1 713 794 4385. (Email: altundag{at}sbcglobal.net).

Key Words: Adjuvant chemotherapy • Non-small cell lung cancer • Elderly patients

We read with interest the article by Matsuoka et al. [1], which evaluated complications and outcomes after pulmonary resection for non-small cell lung cancer (NSCLC) in 40 patients 80–89 years of age. They found that advanced age is not a contraindication to curative resection in patients with stage I NSCLC. After surgery, the disease stage was IA in 21 patients (52.5%), IB in 14 (35.0%), IIB in 3 (7.5%), and IIIA in 2 patients. Recently, several randomized prospective studies support the adjuvant administration of chemotherapy for patients with stages IB–IIIA NSCLC [2–4]. Unfortunately, no patients older than 80 years were included in these trials. However, recent study from M.D. Anderson Cancer Center showed that many patients 80 years and older with stage "wet" IIIB or IV NSCLC may tolerate chemotherapy as compared to patients younger than 80 years of age [5]. Taken all together, since life expectancy in people 80 years and older are long enough to see the benefit of chemotherapy in terms of survival, adjuvant chemotherapy might further be considered in the management of resected stage IB–IIB NSCLC older age patients. Further prospective randomized studies are needed to clarify this issue.

References

  1. Matsuoka H, Okada M, Sakamoto T, Tsubota N. Complications and outcomes after pulmonary resection for cancer in patients 80–89 years of age. Eur J Cardiothorac Surg 2005;28:380-383.[Abstract/Free Full Text]
  2. Arriagada R, Bergman B, Dunant A, Le Chevalier T, Pignon JP, Vansteenkiste J, International Adjuvant Lung Cancer Trial Collaborative Group Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer. N Engl J Med 2004;350:351-360.[Abstract/Free Full Text]
  3. Winton T, Livingston R, Johnson D, Rigas J, Johnston M, Butts C, Cormier Y, Goss G, Inculet R, Vallieres E, Fry W, Bethune D, Ayoub J, Ding K, Seymour L, Graham B, Tsao MS, Gandara D, Kesler K, Demmy T, Shepherd F, National Cancer Institute of Canada Clinical Trials Group, National Cancer Institute of the United States Intergroup JBR.10 Trial Investigators Vinorelbine plus cisplatin vs observation in resected non-small-cell lung cancer. N Engl J Med 2005;352:2589-2597.[Abstract/Free Full Text]
  4. Douillard J, Rosell R, Delena M, Legroumellec A, Torres A, Carpagnano F. ANITA: Phase III adjuvant vinorelbine (N) and cisplatin (P) versus observation (OBS) in completely resected (stage I–III) non-small-cell lung cancer (NSCLC) patients (pts): final results after 70-month median follow-up. Proc Am Soc Clin Oncol 2005;23:624s[abstract 7013].
  5. Altundag O, Fossella F, Ayers G, Zinner G. Many patients 80 years and older with advanced NSCLC tolerate chemotherapy. Lung Cancer 2005;49(Suppl. 2):S32.




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