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Published on: February 13, 2020
Efficacy of functional operability algorithm for octogenarians with primary lung cancer
Hideo Umezu1, Shinichiro Miyoshi, Osamu Araki
1Department of General Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan.
General Thoracic and Cardiovascular Surgery
|January 13, 2012
Summary
A functional operability algorithm helps determine surgical suitability for octogenarian lung cancer patients. This approach allows safe lung resection in elderly individuals, achieving survival rates comparable to younger patients.
Area of Science:
- Geriatric Medicine
- Thoracic Surgery
- Pulmonology
Background:
- Societal aging increases lung cancer incidence.
- Advanced age is a risk factor for thoracotomy complications.
- Need for reliable methods to assess surgical risk in elderly patients.
Purpose of the Study:
- To evaluate a functional operability algorithm for selecting octogenarians for lung cancer surgery.
- To assess the efficacy and safety of thoracotomy in octogenarians using this algorithm.
Main Methods:
- Prospective investigation of 45 octogenarians from 2001-2008.
- Algorithm included pulmonary function tests (FEV1/FVC, ppFEV1, Hugh-Jones index) and exercise testing (anaerobic threshold).
- Surgical outcomes, morbidity, and mortality were reviewed.
Main Results:
- 44 of 45 octogenarians underwent surgery, primarily axilloanterior thoracotomy and lobectomy.
- Post-thoracotomy complications occurred in 65.9% of patients.
- 30-day mortality was 2.3%, hospital mortality 4.5%, with 5-year survival rates of 54.5% (overall) and 79.6% (disease-specific).
Conclusions:
- Careful patient selection using the functional operability algorithm enables octogenarians to tolerate standard lung resection.
- Acceptable morbidity and mortality rates were achieved in this elderly cohort.
- Survival outcomes for octogenarians were comparable to younger lung cancer patients.
