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Pneumonectomy for lung cancer in the elderly: lessons learned from a multicenter study
Fabrizio Minervini1, Gregor J Kocher2, Pietro Bertoglio3
1Department of Thoracic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Pneumonectomy is a viable option for elderly lung cancer patients, even after neoadjuvant therapy. Careful patient selection is key to balancing risks and benefits for improved outcomes in this population.
Area of Science:
- Thoracic Surgery
- Oncology
- Geriatric Medicine
Background:
- Lung cancer predominantly affects individuals over 65.
- Elderly patients often face reluctance for surgical treatment.
- Pneumonectomy poses high risks in older adults, with limited data on neoadjuvant therapy impact.
Purpose of the Study:
- To evaluate outcomes of pneumonectomy in elderly patients (>70 years) with central primary lung malignancy.
- To investigate the influence of age and neoadjuvant treatment on survival and complications.
Main Methods:
- Multicenter retrospective study (7 departments, 2009-2019).
- Included 136 patients aged >70 undergoing pneumonectomy.
- Survival analyzed using Kaplan-Meier and Cox regression.
Main Results:
- Median overall survival was 38 months.
- Neoadjuvant therapy did not increase postoperative complications or mortality.
- Postoperative complications occurred in 54.4% of patients.
Conclusions:
- Age is not an absolute contraindication for pneumonectomy in elderly patients.
- Neoadjuvant treatment is feasible in this cohort.
- A tailored approach with careful patient selection is crucial for risk-benefit assessment.
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