Nonagenarians: Outcomes after lung cancer surgery

An increasing number of nonagenarians are being referred to thoracic surgery clinics for the treatment of non-small cell lung cancer (NSCLC). However, discussions with the patient about surgical resection as a treatment option and the related informed consent process are constrained by the lack of specific information regarding perioperative and short- and long-term outcomes after surgery in this cohort of patients.

We retrospectively identified patients aged ≥90 years who underwent surgical resection for NSCLC at Memorial Sloan Kettering Cancer Center from 2001 to 2021. Risks, complications, and outcomes related to surgical treatment, including neurocognitive complications, length of stay, readmissions, mortality, and survival, were assessed.

During the study period, 17 nonagenarian patients underwent surgical resection for NSCLC at our center; 15 of these patients (88%) received geriatric and/or cardiology consultation before surgery. Fourteen patients (82%) experienced minor complications; however, evidence of postoperative neurocognitive status compromise was not observed. Median length of stay was 5 days; 3 patients (18%) were readmitted within 90 days of discharge. No patients died within 30 or 90 days of surgical resection. Median overall survival was 43 months.

Outcomes among nonagenarian patients who were selected to undergo surgical resection for NSCLC were positive, with overall survival approaching that of the general population of 90-year-olds. The data from this study can enrich the informed consent discussion with nonagenarian patients who are candidates for surgical resection for NSCLC.