The purpose of this study is to examine clinical and pathological features and chemotherapy in the elderly with metastatic non-small cell lung cancer (NSCLC), especially in patients aged 75 years and older.

From the databases at two teaching hospitals during the period from January 1999 to December 2013, medical records of lung cancer patients were retrospectively reviewed. The patient population was divided into two age groups: 75 years or older (the≥75 age group) and less than 75 years (the<75 age group). Time trends were also studied in three time periods: 1999–2003, 2004–2008, and 2009–2013. The years 2004 and 2009 were chosen as cutoff points because of the introduction of gefitinib and bevacizumab, respectively around these years to treat NSCLC patients.

Patients aged 75 years and older comprised 27.3% of 772 consecutive stage IV NSCLC patients; there was an increase in the proportion of≥75 age patients treated with chemotherapy; a trend of improvement in survival of these patients was found. No statistical difference was found in survival between the two age groups of patients treated with chemotherapy (P=0.883). Age≥75 was not an unfavorable prognostic factor in multivariate analysis.

In order to improve survival, detection of appropriate candidates for effective chemotherapy is indeed essential even for the≥75 age group of stage IV NSCLC patients.