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Is Chest Wall Resection Safe in Geriatric Non-Small Cell Lung Cancer?
Ozkan Saydam1, Celal Bugra Sezen1, Melike Ülker1
1Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
The Clinical Respiratory Journal
|November 11, 2025
Summary
Advanced age does not impact outcomes for non-small cell lung cancer (NSCLC) patients undergoing chest wall resection. Surgical approach and disease stage are key prognostic factors for survival and complications.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Geriatric Oncology
Background:
- Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related deaths.
- Chest wall resection is a critical surgical intervention for locally advanced NSCLC.
- Evaluating age-related outcomes in elderly cancer patients is crucial for treatment planning.
Purpose of the Study:
- To assess the safety and efficacy of chest wall resection in NSCLC patients.
- To compare surgical outcomes between younger and older adult patient groups.
- To identify prognostic factors influencing complications and survival in NSCLC surgery.
Main Methods:
- Retrospective analysis of 160 NSCLC patients who underwent chest wall resection (2009-2019).
- Patients were stratified into two age groups: under 70 years (Group A) and 70 years and older (Group B).
- Outcomes analyzed included complication rates, survival rates, and correlation with patient demographics, comorbidities, and surgical procedures.
Main Results:
- Overall complication rate was 28.1%, with no significant difference between age groups.
- Risk of complications was associated with the number of ribs removed (p=0.035).
- Survival rates were 72% for Group A and 93% for Group B (p=0.189). Survival was significantly higher after lobectomy (85%) compared to pneumonectomy (41%, p<0.001).
Conclusions:
- Advanced age is not a prognostic factor for complications or survival after chest wall resection in NSCLC.
- The type of surgical resection (lobectomy vs. pneumonectomy) and disease stage are the most significant prognostic factors.
- These findings support aggressive surgical management in elderly NSCLC patients when indicated by disease stage.
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