WCLC 2025 - Posters & ePosters-P1.07.19 Prospective Cohort Study on Stage 1A Non-Small Cell Lung Cancer in Older Adults (>80 Years): Prevalence, Surgical Treatment, and Complications

P1.07.19 Prospective Cohort Study on Stage 1A Non-Small Cell Lung Cancer in Older Adults (>80 Years): Prevalence, Surgical Treatment, and Complications

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This prospective cohort study from the IELCART investigation at Mount Sinai evaluated prevalence, surgical management, and postoperative outcomes of stage IA non-small cell lung cancer (NSCLC) in octogenarians (age ≥80) compared to younger patients (<80). Among 864 patients undergoing surgical resection of lung tumors ≤30 mm from 2016 to 2024, 13% (n=112) were aged 80 or older. Octogenarians had a median age of 82 versus 69 years in younger patients, with fewer women (51% vs. 62%) and different racial distributions (more White, fewer Black/Asian patients). Smoking histories differed, with fewer current smokers among octogenarians and similar never-smoker proportions.<br /><br />Comorbidities were largely similar, except for less chronic obstructive pulmonary disease (COPD) in the older group. Tumor characteristics were comparable in size and radiologic consistency, although octogenarians had larger tumors (median 18 mm vs. 16 mm), more adenocarcinomas (88% vs. 75%), and more frequent angiolymphatic invasion (41% vs. 29%). Surgical approaches differed: octogenarians underwent fewer lobectomies (21% vs. 36%) and more sublobar resections like wedge resections (71% vs. 56%), despite larger tumors.<br /><br />Postoperative outcomes showed octogenarians had higher overall complication rates (40% vs. 22%), mainly cardiovascular, but pulmonary, infectious complications, ICU admissions, and 30-day readmissions did not differ significantly. Median hospital length of stay was similar at 3 days. These findings indicate that carefully selected octogenarians with early-stage NSCLC can safely undergo surgical resection with acceptable short-term recovery outcomes comparable to younger patients, despite increased complication risks.<br /><br />The study underscores the need for tailored lung cancer screening and treatment strategies for this underrepresented elderly population, supporting surgery as a viable option in appropriately evaluated octogenarians. Further research should optimize screening, patient selection, and management to improve outcomes in this growing age group.

Asset Subtitle

Louis Gros

Meta Tag

Speaker Louis Gros

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

stage IA non-small cell lung cancer

NSCLC

octogenarians

surgical resection

lung tumors

postoperative outcomes

lobectomy

sublobar resection

complication rates

lung cancer screening