Understanding the Impact of Histology on the Post-Surgery Prognosis for Patients 70 Years and Older With I A Stage Non-Small Lung Cancer

Abstract Objectives: Few studies investigated whether the types of histology had an influence on the postsurgical prognosis for patients 70 years and older with Ⅰ A stage non-small lung cancer (NSCLC). Methods: The study population in our study were obtained from the Surveillance, Epidemiology, and End Results (SEER) Program.Results: A total of 10,376 eligible patients were included in our study. In both lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LSQCC) patients with TS ≤10 mm, sublobar resection (SR) achieved similar overall survival (OS) (LUAD: HR=0.843, 95% CI (0.673, 1.062), P=0.149; LSQCC: HR=0.799, 95 %CI (0.615, 0.036), P=0.091) and LCSS (LUAD: HR=1.074, 95% CI (0.626, 1.843), P=0.795; LSQCC: HR=0.987, 95 % CI (0.532, 1.833), P=0.967) to lobectomy (LT). For LUAD patients with TS >10 mm &≤20 mm, LT was associated with better OS (HR=0.785, 95% CI (0.703, 878), P<0.001) but not LCSS (HR=0.962, 95% CI (0.766, 1.209), P=0.741); while for LSQCC, LT yielded similar OS (HR=0.864, 95% CI (0.746, 1.005), P=0.051) and LCSS (HR=0.872, 95% CI (0.675, 1.128), P=0.297). LUAD patients with TS>20 mm &≤30 mm received SR were at a significant risk of reduction of OS (HR=0.816, 95% CI (0.709, 0.938), P=0.004) but not LCSS (HR=0.954, 95% CI (0.732, 1.244), P=0.729); while for LSQCC, patients received LT had a better OS (HR=0.742, 95% CI (0.624, 0.883), P<0.001) but not LCSS (HR=0.776, 95% CI (0.563, 1.071), P=0.123). Conclusion: The postsurgical prognosis differed in patients with different histology, and SR maybe acceptable for elderly LUAD patients with TS ≤10 mm and LSQCC patients with TS ≤20 mm.