Is high age a contraindication to pulmonary resection?

Area of Science:

• Thoracic Surgery
• Geriatric Oncology
• Pulmonary Medicine

Background:

• Aging global population leads to increased diagnoses of operable primary pulmonary malignancy in elderly patients.
• Pulmonary resection is a common treatment for lung cancer and other thoracic lesions.
• Evaluating post-operative outcomes in elderly surgical patients is crucial.

Purpose of the Study:

• To assess and compare post-operative outcomes in elderly patients undergoing pulmonary resection versus younger patients.
• To determine the safety and efficacy of standard surgical treatments for lung cancer in seniors.

Main Methods:

• Retrospective analysis of 424 patients undergoing anatomical pulmonary resection (2011-2020).
• Comparison of open procedures (328) versus VATS lobectomy (96).
• Evaluation of 30-day morbidity and mortality using a modified Clavien-Dindo classification across age subgroups (under 55, 55-64, 65-74, 75+).

Main Results:

• No statistically significant difference in complication rates was observed between age groups (p=0.220).
• Standard surgical treatment, including lobectomy with mediastinal lymphadenectomy, demonstrated safety in well-indicated elderly patients.

Conclusions:

• Standard lobectomy with lymphadenectomy is safe for selected elderly patients with non-small cell lung carcinoma.
• Comparable complication rates can be achieved in elderly patients through careful preoperative assessment and tailored resection extent.
• Sublobar resection or radiotherapy may be considered for high-risk elderly patients; comparable oncological outcomes are achievable for seniors over 70, considering life expectancy.