Elective Lung Resections in the Elderly: Where Do We Draw the Line?

Area of Science:

• Thoracic Surgery
• Geriatric Oncology
• Pulmonary Medicine

Background:

• Increasing longevity leads to more elderly patients diagnosed with resectable non-small cell lung cancer (NSCLC).
• Limited literature exists on surgical outcomes for patients over 85 years old with NSCLC.

Purpose of the Study:

• To compare outcomes of elective lung resection for NSCLC in patients over 85 years old versus those aged 80-84.
• To evaluate the safety and feasibility of surgical intervention in the oldest patient demographic.

Main Methods:

• Retrospective analysis of patients undergoing elective lung resection for NSCLC between 2012-2015.
• Inclusion of 76 patients aged 80-84 and 18 patients aged 85+.
• Follow-up period of 3-7 years.

Main Results:

• Significant increase in Thoracic Surgery Scoring System and reduction in transfer factor in the 85+ group.
• No in-hospital deaths occurred in the 85+ group, compared to 3.9% in the 80-84 group.
• Study involved 701 total elective lung resections.

Conclusions:

• Elective lung resection for early non-small cell lung cancer is safe in patients 85 years and older.
• Parenchymal-sparing procedures may be beneficial for this higher-risk population.
• This study supports surgical intervention for selected elderly NSCLC patients.