Lobar and sub-lobar lung resection in octogenarians with early stage non-small cell lung cancer: factors affecting surgical outcomes and long-term results
- 18 November 2014
- journal article
- research article
- Published by Springer Science and Business Media LLC in General Thoracic and Cardiovascular Surgery
- Vol. 63 (4), 222-230
- https://doi.org/10.1007/s11748-014-0493-8
Abstract
Consensus exists as to the concept that surgical therapy should not be denied based on older age alone. Elderly lung cancer patients with multiple morbidities are increasingly referred for surgical care. The aim of this study was to evaluate the surgical outcomes and the long-term survival in octogenarians with early-stage non-small cell lung cancer. Between January 2000 and December 2010, we identified 73 octogenarians who underwent intended curative lung resection for lung cancer in three different thoracic surgery departments. Two surgical groups were defined: patients who underwent lobar resection (group A) and patients who underwent sub-lobar resection (group B). The in-hospital mortality was 2.7 % without difference between groups. Group B had a lower incidence of post-operative complications, in particular respiratory complications. Chronic renal failure, multi pre-operative comorbidities and type of resection were risk factors for post-operative morbidity. After a mean follow-up time of 63.8 months, the overall survival at 1, 3 and 5 years was 96, 83 and 60 %, respectively. The low-respiratory reserve was associated with worse long-term survival. The intra-operative and post-operative factors able to influence survival were: the cN status, recurrence of disease and local versus systemic recurrence. The type of operation did not influence survival. In our experience, surgery is a safe and justifiable option for octogenarian patients with early stage NSCLC. Sublobar resection provides an equivalent in-hospital mortality and long-term survival in comparison with open lobectomy but with less postoperative morbidity. Further large-scale randomized studies are necessary to confirm our results.Keywords
This publication has 24 references indexed in Scilit:
- Is limited pulmonary resection equivalent to lobectomy for surgical management of stage I non-small-cell lung cancer?Interactive CardioVascular and Thoracic Surgery, 2012
- Surgical treatment of lung cancer in the octogenarians: results of a nationwide auditEuropean Journal of Cardio-Thoracic Surgery, 2011
- Surgical treatment of non-small cell lung cancer in octogenariansInteractive CardioVascular and Thoracic Surgery, 2011
- Pulmonary Resection in Patients Aged 80 Years or Over with Clinical Stage I Non-small Cell Lung Cancer: Prognostic Factors for Overall Survival and Risk Factors for Postoperative ComplicationsJournal of Thoracic Oncology, 2009
- EORTC Elderly Task Force and Lung Cancer Group and International Society for Geriatric Oncology (SIOG) experts’ opinion for the treatment of non-small-cell lung cancer in an elderly populationAnnals of Oncology, 2009
- The New Lung Cancer Staging SystemSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2009
- Effect of Age on Survival of Clinical Stage I Non-Small-Cell Lung CancerAnnals of Surgical Oncology, 2009
- The choice among past trends as a basis for the prediction of future trends in old-age mortalityPopulation Studies, 2007
- Lung cancer in octogenarians: factors affecting long-term survival following resectionEuropean Journal of Cardio-Thoracic Surgery, 2007
- Lung Cancer in Octogenarians: Factors Affecting Morbidity and Mortality After Pulmonary ResectionThe Annals of Thoracic Surgery, 2006