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Surgery for lung cancer in the elderly
T Sioris1, J Salo, V Perhoniemi
1Department of Cardiothoracic Surgery, Helsinki University Hospital, Finland.
Scandinavian Cardiovascular Journal : SCJ
|October 12, 1999
Summary
Elderly patients aged 75 and over can safely undergo lung cancer surgery, including those over 80. Lobectomy is preferred, but less extensive surgery may be suitable for patients with comorbidities.
Area of Science:
- Thoracic Surgery
- Geriatric Oncology
- Pulmonary Medicine
Background:
- Lung cancer surgery in elderly patients (>=75 years) requires careful assessment.
- Optimal surgical candidates and resection strategies for this demographic remain areas of investigation.
Purpose of the Study:
- To evaluate the appropriateness and outcomes of lung cancer surgery in elderly patients.
- To identify optimal patient selection and resection procedures for curative intent in this population.
Main Methods:
- Retrospective follow-up of 75 patients aged >=75 years who underwent lung cancer surgery between 1976 and 1996.
- Analysis of perioperative mortality, morbidity, and long-term survival based on resection type and patient age groups (75-79 vs. >=80 years).
Main Results:
- Perioperative mortality was 9% and morbidity 29%, with 21% major complications.
- Cumulative 5-year survival was 32%; cancer-related survival ranged from 61-79%.
- No significant differences in mortality, morbidity, or survival were observed between age groups (75-79 vs. >=80 years) or between lobectomy and limited resection in Stage I cancer.
Conclusions:
- Age, including over 80 years, is not a contraindication for curative lung cancer resection.
- Lobectomy is generally the preferred surgical approach, but less radical resections may be considered for patients with comorbidities.
- The individual surgical risk must be balanced against potential long-term benefits, especially for more extensive resections.