Surgery for non-small cell carcinoma in geriatric patients: 15-year experience

The purpose of this study was to determine the clinical patterns, short- and long-term survival in elderly patients after surgery for non-small cell lung carcinoma. The 273 patients aged over 70 years who underwent curative resection from 1986 to 2001 were retrospectively assessed. Mean age was 73.2+/-3.1 years, (11% were>80 years). The mean follow-up was 31 months. Standard procedures were used: 151 lobectomies, 49 bilateral lobectomies, 42 pneumonectomies, 9 sleeve resections, and 22 wedge resections. The 30-day mortality was 5.4%. Multivariate analysis showed that extended procedures, male sex, and age were predictors of mortality. Overall survival rates at 5, 10, and 15 years were 35.6%, 10.5%, and 2.5%, respectively. Advanced disease stage, low forced expiratory volume in 1 second, and previous cardiac disease were independent predictors that adversely influenced survival. Geriatric patients with non-small cell lung carcinoma can undergo resection safely with acceptable long-term survival. Lobectomy is the procedure of choice, extended resections should only be carried out in highly selected patients. Careful attention to preoperative clinical staging is important as the elderly beyond the early stage of disease fare poorly. Surgery is justified for the treatment of stage I-II lung cancer.