Outcomes of Video-Assisted Thoracoscopic Lobectomy in Octogenarians Following Enhanced Recovery After Surgery...

Area of Science:

• Thoracic surgery
• Oncology
• Geriatric medicine

Background:

• Minimally invasive surgery and ERAS protocols improve outcomes for early-stage lung cancer.
• Octogenarians are increasingly considered for curative lung cancer treatment.
• Limited evidence exists on short-term outcomes of ERAS-guided VATS lobectomy in octogenarians.

Purpose of the Study:

• To evaluate perioperative outcomes in octogenarians undergoing VATS lobectomy.
• To assess specific challenges in octogenarians within an ERAS protocol.
• To determine the safety and feasibility of VATS lobectomy in this age group.

Main Methods:

• Retrospective observational study (2009-2024) of adult VATS lobectomy patients in an ERAS program.
• Standardized care and ERAS protocol followed by all patients.
• Additional preoperative risk assessment for patients aged ≥80 years.

Main Results:

• 335 octogenarians (7.3%) had comparable overall complication rates to younger patients.
• Octogenarians had a slightly longer length of stay (4 vs 3 days) and higher rates of postoperative atrial fibrillation (12% vs 7.6%).
• 30-day readmission (11.9%) and mortality (1.8%) were not statistically different; octogenarian VATS lobectomy increased from 2.5% to 11.7%.

Conclusions:

• VATS lobectomy within an ERAS framework is safe and feasible for carefully selected octogenarians.
• Short-term outcomes are acceptable, supporting surgical treatment regardless of age alone.
• Chronological age should not be a barrier to curative surgical treatment for early-stage lung cancer.