Prognostic factors and survival analysis across different age groups in elderly patients with ES-SELC.

Abstract

e20115 Background: This study aims to investigate the prognostic factors affecting elderly SCLC patients, providing valuable insights to enhance their quality of life and improve survival outcomes. Methods: This single-center retrospective study analyzed data from 270 elderly patients with extensive-stage small cell lung cancer (ES-SCLC) who received treatment at the Fourth Hospital of Hebei Medical University. The dataset included clinicopathological characteristics, baseline peripheral blood biomarkers, treatment strategies, prognostic outcomes, and treatment efficacy indicators. Kaplan-Meier analysis was used to construct survival curves, while univariate and multivariate Cox regression analyses were conducted to identify prognostic factors influencing outcomes in elderly patients with ES-SCLC. Differences were considered statistically significant at P < 0.05. Results: As of the final follow-up on October 15, 2024, the median follow-up duration was 12 months. The 1-year, 2-year, and 3-year survival rates for elderly patients with ES-SCLC were 23%, 15%, and 13%, respectively, reflecting the poor prognosis associated with this patient population. The median progression-free survival (PFS) for elderly patients aged 65–74 years and those aged ≥75 years was 7 months and 4 months, respectively (P < 0.01). Similarly, the median overall survival (OS) for patients aged 65–74 years and those aged ≥75 years was 14 months and 12 months, respectively (P < 0.01), indicating a significant difference in survival outcomes between the two age groups. Univariate Cox analysis revealed that chemotherapy, advanced age (≥75 years), and suboptimal treatment response were significantly associated with shorter PFS. Additionally, advanced age (≥75 years), smoking history, bone metastases, absence of thoracic radiotherapy, elevated lactate dehydrogenase (LDH >250 U/L), suboptimal treatment response, and shorter PFS (≤7.5 months) were significantly associated with poorer overall survival (OS).Multivariate Cox analysis identified chemotherapy, advanced age (≥75 years), and suboptimal treatment response as independent prognostic factors significantly associated with shorter PFS in elderly patients with ES-SCLC. Furthermore, bone metastases, absence of thoracic radiotherapy, elevated LDH (LDH >250 U/L), and shorter PFS (≤7.5 months) were determined to be independent prognostic factors adversely affecting OS in this patient population. Conclusions: The prognosis of elderly patients with SCLC is influenced by a range of factors, including treatment regimens, age, smoking history, and serological markers. Ongoing research and the advancement of novel therapeutic strategies offer promise for the development of more personalized and precise treatment approaches, with the ultimate goal of improving survival outcomes and quality of life for this vulnerable patient population.