Temporal trends and predictors of perioperative chemotherapy use in elderly patients with resected nonsmall cell lung cancer

Jue Wang, Yong Fang Kuo, Jean Freeman, Avi Markowitz, James Goodwin

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND. The authors assessed patterns of perioperative chemotherapy use in elderly patients with resected stage I, II, or IIIA nonsmall cell lung cancer (NSCLC) from 1992 to 2002. METHODS. By using data from the Surveillance, Epidemiology, and End Results Program, 11,807 patients were identified who had resected stage I, II, or IIIA NSCLC between 1992 and 2002 and survived >120 days beyond diagnosis. The rate of perioperative chemotherapy use was measured by calendar year, and the association between clinical/demographic characteristics and the receipt of chemotherapy was examined by using logistic regression. RESULTS. In total, 957 patients with stage I, II, or IIIA NSCLC (8.1% of the study population) received perioperative chemotherapy. The proportion of patients receiving chemotherapy for stage I NSCLC changed little during the study period. Of 3230 patients with stage II and IIIA NSCLC, 609 patients (18.9%) received chemotherapy, 423 patients (13%) received chemotherapy combined with radiation. 452 patients (15.6%) received adjuvant chemotherapy, and 66 patients (2.3%) received neoadjuvant chemotherapy. The use of chemotherapy increased significantly among patients who were diagnosed after 1994 relative to patients who were diagnosed in 1992 after controlling for sociodemographic and treatment characteristics (P < .001). There was significantly increased use of new-generation chemotherapy agents, such as carboplatin and taxanes (P < .001). The proportion of patients receiving combined-modality therapy also increased significant (P < .001). Younger age, being married, having advanced-stage tumor or adenocarcinoma, having a later diagnosis year, receiving radiation, and seeing an oncologist were predictors for the receipt of chemotherapy (P < .001). CONCLUSIONS. A substantial proportion of Medicare beneficiaries with NSCLC received perioperative chemotherapy. Specifically designed prospective trials that focus on older patients are needed.

Original languageEnglish (US)
Pages (from-to)382-390
Number of pages9
JournalCancer
Volume112
Issue number2
DOIs
StatePublished - Jan 15 2008

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Non-Small Cell Lung Carcinoma
Drug Therapy
SEER Program
Taxoids
Combined Modality Therapy
Delayed Diagnosis
Carboplatin
Adjuvant Chemotherapy
Medicare
Adenocarcinoma
Logistic Models
Demography
Radiation

Keywords

  • And End Results-Medicare database
  • Chemotherapy
  • Epidemiology
  • Medicare beneficiaries
  • Nonsmall cell lung cancer
  • Surveillance

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Temporal trends and predictors of perioperative chemotherapy use in elderly patients with resected nonsmall cell lung cancer. / Wang, Jue; Kuo, Yong Fang; Freeman, Jean; Markowitz, Avi; Goodwin, James.

In: Cancer, Vol. 112, No. 2, 15.01.2008, p. 382-390.

Research output: Contribution to journalArticle

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title = "Temporal trends and predictors of perioperative chemotherapy use in elderly patients with resected nonsmall cell lung cancer",
abstract = "BACKGROUND. The authors assessed patterns of perioperative chemotherapy use in elderly patients with resected stage I, II, or IIIA nonsmall cell lung cancer (NSCLC) from 1992 to 2002. METHODS. By using data from the Surveillance, Epidemiology, and End Results Program, 11,807 patients were identified who had resected stage I, II, or IIIA NSCLC between 1992 and 2002 and survived >120 days beyond diagnosis. The rate of perioperative chemotherapy use was measured by calendar year, and the association between clinical/demographic characteristics and the receipt of chemotherapy was examined by using logistic regression. RESULTS. In total, 957 patients with stage I, II, or IIIA NSCLC (8.1{\%} of the study population) received perioperative chemotherapy. The proportion of patients receiving chemotherapy for stage I NSCLC changed little during the study period. Of 3230 patients with stage II and IIIA NSCLC, 609 patients (18.9{\%}) received chemotherapy, 423 patients (13{\%}) received chemotherapy combined with radiation. 452 patients (15.6{\%}) received adjuvant chemotherapy, and 66 patients (2.3{\%}) received neoadjuvant chemotherapy. The use of chemotherapy increased significantly among patients who were diagnosed after 1994 relative to patients who were diagnosed in 1992 after controlling for sociodemographic and treatment characteristics (P < .001). There was significantly increased use of new-generation chemotherapy agents, such as carboplatin and taxanes (P < .001). The proportion of patients receiving combined-modality therapy also increased significant (P < .001). Younger age, being married, having advanced-stage tumor or adenocarcinoma, having a later diagnosis year, receiving radiation, and seeing an oncologist were predictors for the receipt of chemotherapy (P < .001). CONCLUSIONS. A substantial proportion of Medicare beneficiaries with NSCLC received perioperative chemotherapy. Specifically designed prospective trials that focus on older patients are needed.",
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AU - Freeman, Jean

AU - Markowitz, Avi

AU - Goodwin, James

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N2 - BACKGROUND. The authors assessed patterns of perioperative chemotherapy use in elderly patients with resected stage I, II, or IIIA nonsmall cell lung cancer (NSCLC) from 1992 to 2002. METHODS. By using data from the Surveillance, Epidemiology, and End Results Program, 11,807 patients were identified who had resected stage I, II, or IIIA NSCLC between 1992 and 2002 and survived >120 days beyond diagnosis. The rate of perioperative chemotherapy use was measured by calendar year, and the association between clinical/demographic characteristics and the receipt of chemotherapy was examined by using logistic regression. RESULTS. In total, 957 patients with stage I, II, or IIIA NSCLC (8.1% of the study population) received perioperative chemotherapy. The proportion of patients receiving chemotherapy for stage I NSCLC changed little during the study period. Of 3230 patients with stage II and IIIA NSCLC, 609 patients (18.9%) received chemotherapy, 423 patients (13%) received chemotherapy combined with radiation. 452 patients (15.6%) received adjuvant chemotherapy, and 66 patients (2.3%) received neoadjuvant chemotherapy. The use of chemotherapy increased significantly among patients who were diagnosed after 1994 relative to patients who were diagnosed in 1992 after controlling for sociodemographic and treatment characteristics (P < .001). There was significantly increased use of new-generation chemotherapy agents, such as carboplatin and taxanes (P < .001). The proportion of patients receiving combined-modality therapy also increased significant (P < .001). Younger age, being married, having advanced-stage tumor or adenocarcinoma, having a later diagnosis year, receiving radiation, and seeing an oncologist were predictors for the receipt of chemotherapy (P < .001). CONCLUSIONS. A substantial proportion of Medicare beneficiaries with NSCLC received perioperative chemotherapy. Specifically designed prospective trials that focus on older patients are needed.

AB - BACKGROUND. The authors assessed patterns of perioperative chemotherapy use in elderly patients with resected stage I, II, or IIIA nonsmall cell lung cancer (NSCLC) from 1992 to 2002. METHODS. By using data from the Surveillance, Epidemiology, and End Results Program, 11,807 patients were identified who had resected stage I, II, or IIIA NSCLC between 1992 and 2002 and survived >120 days beyond diagnosis. The rate of perioperative chemotherapy use was measured by calendar year, and the association between clinical/demographic characteristics and the receipt of chemotherapy was examined by using logistic regression. RESULTS. In total, 957 patients with stage I, II, or IIIA NSCLC (8.1% of the study population) received perioperative chemotherapy. The proportion of patients receiving chemotherapy for stage I NSCLC changed little during the study period. Of 3230 patients with stage II and IIIA NSCLC, 609 patients (18.9%) received chemotherapy, 423 patients (13%) received chemotherapy combined with radiation. 452 patients (15.6%) received adjuvant chemotherapy, and 66 patients (2.3%) received neoadjuvant chemotherapy. The use of chemotherapy increased significantly among patients who were diagnosed after 1994 relative to patients who were diagnosed in 1992 after controlling for sociodemographic and treatment characteristics (P < .001). There was significantly increased use of new-generation chemotherapy agents, such as carboplatin and taxanes (P < .001). The proportion of patients receiving combined-modality therapy also increased significant (P < .001). Younger age, being married, having advanced-stage tumor or adenocarcinoma, having a later diagnosis year, receiving radiation, and seeing an oncologist were predictors for the receipt of chemotherapy (P < .001). CONCLUSIONS. A substantial proportion of Medicare beneficiaries with NSCLC received perioperative chemotherapy. Specifically designed prospective trials that focus on older patients are needed.

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KW - Epidemiology

KW - Medicare beneficiaries

KW - Nonsmall cell lung cancer

KW - Surveillance

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