Prognostic Effect of Age on Survival of Patients with Stage I Adenocarcinoma of the Lung

초록

Aims and background: It is still unclear whether age is an independent prognostic factor in patients with stage I NSCLC. Methods: Five hundred sixty nine patients with pstage I adenocarinoma underwent surgical resection as first treatment were included. The effect on overall survival of age, gender, smoking habits, Charlson comorbidity index score (CCIS), type of surgery, tumor size and lymphatic or blood vessel invasion were analyzed. Results: Men, ever smokers, higher CCIS, adenocarcinoma, and higher probability of taking adjuvant chemotherapy were more common clinical characteristics in proportion as age increases. In addition to different cut-off values of age, gender, smoking habit, CCIS, tumor size and lymphatic or blood vessel invasion were significantly associated with overall survival of the patients in Kaplan-Meier analysis (log-rank P < 0.001, P = 0.029, P < 0.001, P = 0.001, P = 0.001 and P = 0.007, respectively). Moreover increasing age was a prominent determinant for worse prognosis after adjustment for these confounding variables using a Cox proportional hazard model (adjusted hazard ratio = 1.049, 95% confidence interval = 1.027&#8211;1.072, P < 0.001). Conclusions: These findings suggest that age is an important determinant of overall survival in patients with stage I adenocarcinoma. Therefore, age should be considered in classifying the patients into groups of higher or lower risk for death as well as designing clinical trials.