Lung cancer in patients ≥ 80 years of age: Analysis of the national surveillance, epidemiology and end results (SEER) database

7156 Background: Lung cancer is a disease of the elderly with median age at diagnosis of 70 years. In spite of this, the very elderly (patients ≥ 80 years) group has not been well studied. We analyzed the national SEER database to evaluate outcome of the disease in this subgroup. Methods: All patients with primary lung cancer in the national SEER database from 1988–1997 were included, and grouped into those <80 yrs vs. those ≥80 yrs at the time of diagnosis. We compared the 2 groups for stage distribution, 3-yr & 5-yr survival, survival based on histology, sex, race, stage and treatment. The 5-yr relative survival rate, adjusted for the normal life expectancy, was utilized except for the 3-yr survival comparison. The SEER program, Stat 6.1.4, was used for analysis and all p-values were 2-sided. Results: Of the 129,003 cases of lung cancer registered over 10 years, 14,614 (11%) occurred in patients ≥80 yrs. Overall survival at 3 and 5yrs was inferior in the octogenarian group, {11.8% vs. 20% and 8.3% vs. 16.2%, respectively (p < 0.0001)}. The inferior survival was observed in both males and females {7.1% vs. 14.3% and 9.6% vs. 18.9%, respectively (p < 0.0001)} and with non-small cell histology {9.1% vs. 18.3% (p < 0.0001)}. Stage-specific analysis revealed the same trend {24.9% vs. 46.9% - stage I, 19.1% vs. 30.4% - stage II, 3.1% vs. 9.0% - stage III and 1.1% vs. 1.8% - stage IV (p < 0.0001 for all comparisons)}. Irrespective of race, elderly patients fared worse: 6.9% vs. 12.8% in blacks, 8.4% vs. 16.7% in white and 8.4% vs. 16.3% in other racial groups (p < 0.0001 for all comparisons). Although, therapy (surgery or radiation) benefited both groups, treated elderly group performed worse than younger group {4.9% vs. 8.1% (p < 0.0001) and 45% vs. 45.7% (p < 0.02) with radiation and surgery respectively}. However, only 58% of elderly patients received surgery or radiation therapy compared to 80% of patients <80 yrs. Conclusion: In general, very elderly patients with lung cancer have a worse clinical outcome than younger patients. This is irrespective of histology, stage of disease, sex, gender or race. The worse outcome in the elderly may be due to a larger proportion of them not receiving treatment. No significant financial relationships to disclose.