Lung cancer resection in octogenarians: a reasonable approach for our aging population

Lung cancer is the third most common cancer but accounts for more deaths per year than breast, prostate, and colon cancer combined. Traditionally, age older than 80 years was a relative contraindication to pulmonary resection. Recently, multiple studies have validated the safety and efficacy of pulmonary resections in octogenarians. The purpose of this study was to review the authors' regional teaching hospital's experience with lung resections in octogenarians. A retrospective analysis of 20 octogenarians who underwent pulmonary resection for lung cancer from 1999 to 2004 was performed. Average age was 82.1 years. Ten patients (50%) were male. Seventeen patients (85%) had at least one comorbidity. Ten patients (50%) had stage I disease, with squamous cell being the most common histologic type (35%). Lobectomy, performed in 12 patients (60%), was the most common technique of resection. There was a 45 per cent overall complication rate and a 20 per cent major complication rate. The overall perioperative mortality rate was 10 per cent. Survival probability estimates show overall survival at 1 year to be 59 per cent and at 2 years to be 39 per cent. Overall median survival was 21.1 months. We conclude that octogenarians can undergo anatomic resections for lung cancer with acceptable morbidity and survival.