Older patients treated for lung and thoracic cancers: unplanned hospitalizations and overall survival

Abstract Background Lung cancer affects older adults and is the leading solid tumor in terms of death. Comprehensive Geriatric Assessment (CGA) is recommended before cancer treatment to guide therapy management. Methods This study was conducted between September 2015 and January 2019. During this period of time, all consecutive older outpatients referred for a CGA before initiation of lung or thoracic tumor treatment were included. The objectives were to describe the impact of geriatric factors on unplanned hospitalizations and overall survival (OS). The study was approved by a local ethics committee. Findings Overall, 228 patients were recruited. The median age was 78.7 ± 5 years. The majority of patients were diagnosed with non-small-cell lung cancer (82%) and the most common treatment was systemic therapy (40.4%). In multivariate analysis, factors associated with unplanned hospitalizations within the first 3 months were male gender (aOR 3.3; 95% CI [1.5-7.2]), systemic therapy (aOR 2.6; 95% CI [1.1-6.2]), and fall history (aOR 3.6; 95% CI [1.6-8.2]). Factors associated with a decrease in OS in the multivariate Cox model analysis were male gender (HR 3.9; 95% CI [2.1-7.3]), stage IV (HR 1.6; 95% CI [1.0-2.6]), G8 ≤ 14 (HR 3.5; 95% CI [1.1-11.4]), systemic therapy (HR 2.6; 95% CI [1.2-5.5]), ECOG-PS≥2 (HR 2.0; 95% CI; [1.2-3.4]), impaired handgrip strength (HR 1.6; 95% CI; [1.0-2.5]). Interpretation G8 score and handgrip strength are important to predict overall survival in older adults treated for thoracic tumor. In the GCA, fall history was associated with unplanned hospitalization.