Prognostic factors affecting mortality in elderly, low body mass index, and poor performance status groups with lung cancer: analysis of the 2016 Korean Association of Lung Cancer Registry (KALC-R) database

Background: Recent advancements in lung cancer treatment have brought about a paradigm shift that raises the possibility of treatment for populations who were previously not considered for lung cancer therapy.

of such advanced therapies in vulnerable populations. This study aims to provide real-world evidence on treatment outcomes across varying clinical conditions, with a focus on patients with frail conditions such as old age, low BMI, or reduced performance status, who are often underrepresented. Methods: This study analyzed data from the Korean Association of Lung Cancer Registry (KALC-R) cohort—the third nationwide survey, a multi-center cancer registry from 13 regional cancer centers and 38 hospitals from which significant number of registrations were made. In 2016, the KALC-R registered 2,808 patients who were newly diagnosed with lung cancer. Results: Older age, male sex, lower body mass index (BMI), squamous cell carcinoma, poor performance status, lower lung function, higher clinical stage and non-surgical treatment or best supportive care only were significant factors for mortality in non-small cell lung cancer (NSCLC) patients. Also, in patients with small cell lung cancer (SCLC), older age, lower BMI, poor performance status, higher clinical stage, and best supportive care only compared to anti-cancer treatment were significantly associated with mortality. Both NSCLC and SCLC patients who receive best supportive care only have a higher risk of mortality compared to those who receive surgical treatment among elderly patients (≥65 years), patients with poor performance status, and those with low BMI (<20 kg/m²). Conclusions: A select group of patients with vulnerable conditions, such as old age, low BMI, and poor performance status, may benefit from active anti-cancer treatment.