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Decrease in performance status after lobectomy mean poor prognosis in elderly lung cancer patients.

Yo Kawaguchi^1,2, Jun Hanaoka¹, Yasuhiko Oshio¹

¹Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.

Journal of Thoracic Disease

|July 26, 2017

Summary

Maintaining performance status (PS) after lung cancer lobectomy is crucial for elderly patients. A decline in PS post-surgery indicates a poor prognosis, highlighting the need for careful patient selection.

Keywords:

Lung cancer elderly patients lobectomy performance status

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Area of Science:

Oncology
Thoracic Surgery
Geriatric Medicine

Background:

Lung cancer surgery offers the best cure for resectable cases, but elderly patients often receive suboptimal treatment due to fears of decreased performance status (PS) after lobectomy.
Clearer data on post-lobectomy survival and PS changes are needed to guide surgical decisions in older adults.

Purpose of the Study:

To evaluate the impact of performance status (PS) changes after lobectomy on survival outcomes in elderly patients with non-small cell lung cancer (NSCLC).
To identify predictors of reduced postoperative PS in this patient population.

Main Methods:

Retrospective review of 137 patients aged 75+ undergoing lobectomy for NSCLC (2004-2014).
Patients were grouped based on postoperative vs. preoperative Eastern Cooperative Oncology Group PS: Group 1 (no change), Group 2 (decrease).
Comparison of patient characteristics and survival between the two groups.

Main Results:

Five-year survival was 47.4% in Group 1 (maintained PS) versus 0% in Group 2 (reduced PS) (P<0.001).
History of cardiac ischemia and squamous cell carcinoma were significant predictors of reduced postoperative PS.

Conclusions:

Maintenance of PS after lobectomy is associated with a good prognosis in elderly lung cancer patients.
A reduction in PS post-lobectomy predicts an extremely poor prognosis.
Cardiac ischemia history and squamous cell carcinoma are potential risk factors for PS decline, necessitating careful patient evaluation for lobectomy.