[Resection of Lung Cancer in Old Patients - Does Demographic Change Cause a Rethink?]

Area of Science:

• Thoracic Surgery
• Geriatric Medicine
• Oncology

Background:

• Demographic shifts in Germany show an aging population.
• The World Health Organization defines patients over 75 as elderly.
• The tolerance and outcomes of thoracic surgery in elderly patients remain unclear, often influenced by surgeon experience.

Purpose of the Study:

• To evaluate the safety and outcomes of thoracic surgery in elderly patients (over 75) compared to younger age groups.
• To determine if age alone is a limiting factor for thoracic surgery.
• To assess the impact of specialized centers on surgical outcomes in elderly patients.

Main Methods:

• Analysis of data from the German Thorax Register (2016-2018).
• Inclusion of 1357 patients, with 658 having Stage I-II lung cancer.
• Patients categorized into three age groups: <65, 65-75, and >75 years.

Main Results:

• Patients over 75 (Group III) did not exhibit increased postoperative complication rates (52.9%) compared to other groups.
• Group III showed better outcomes regarding pulmonary complications (pneumonia: 12.9%) than Group II (19.2%).
• Mortality was lowest in the German Thorax Register centers (1.3% for Group III) compared to the national average (3.78%).
• A higher proportion of VATS procedures were performed in German Thorax Register centers.

Conclusions:

• Elderly patients over 75 can safely undergo thoracic surgery with acceptable complication rates.
• Specialized centers demonstrate improved outcomes and lower mortality for elderly patients undergoing thoracic surgery.
• Age should not be the sole criterion for excluding elderly patients from thoracic surgery; suitability for surgery is key.