Do Older Patients with Stage IB Non-Small-Cell Lung Cancer Obtain Survival Benefit from Surgery? A Propensity Score Matching Study Based on the SEER Database

Abstract Background: Although surgery is the preferred treatment method for early-stage non-small-cell lung cancer (NSCLC), more than a third of older patients with stage IB NSCLC didn’t receive surgical treatment. Methods: Data of patients with NSCLC was downloaded from the SEER (Surveillance, Epidemiology, and End Results) database, converted from the 7th edition staging to those of the 8th edition staging, and then screened out older patients (aged ≥65 years at diagnosis) with stage IB NSCLC. The propensity score matching (PSM) method was were balanced the distribution proportions of clinical characteristics between the surgery and no surgery groups.Results: After 1:1 propensity score matching, the distribution proportions of clinical characteristics were balanced between the surgery and no surgery groups (P > 0.05, all). The overall survival and disease-specific survival of patients in the surgery group were significantly better than those in the no-surgery group (P < 0.001, both). Furthermore, subgroup analysis showed that receiving surgery was a protective factor for overall survival and disease-specific survival of patients in all clinical character-related subgroups. Ultimately, univariate and multivariate Cox regression analyses showed that gender, tumor size, tumor grade, and tumor classification were independent prognostic factors for overall survival and disease-specific survival in patients undergoing surgery. Conclusions: Older patients with Stage IB NSCLC should opt for surgery without hesitation. This study is expected to provide strong evidence-based medical evidence for the surgical treatment of these patients.