Evaluating the Role of Advanced Age and Risk Factors in Postoperative Outcomes Following Major Lung Cancer Resection

The incidence of lung cancer increases with age. On average, patients diagnosed with lung cancer are about 70 years. It is known that older patients are more prone to complications after major lung resection due to physiological changes; however, there is still a lack of knowledge of predictive factors associated with a higher complication risk.

In this study the association of age and postoperative complication rates in lung cancer patients is analyzed. Further, predictors of postoperative complications in the era of minimally invasive surgery in older patients are identified.

We retrospectively analyzed 180 consecutive patients with pathologically proven lung adenocarcinoma and squamous cell carcinoma. Patients were categorized into septuagenarians and octogenarians. Univariate and multivariate analyses were conducted to detect risk factors of postoperative morbidity.

There were 141 (78.33%) and 39 patients (21.67%) in the septuagenarian group and octogenarian group, respectively. 67 (37.2%) patients experienced postoperative complications. The thirty-day mortality rate was 1.6%. The groups did not differ in terms of postoperative complications. Upon multivariate analysis, ECOG score ≥ 1 (p = 0.032), lowered FEV1/FVC (p = 0.029), and hypoalbuminemia (p = 0.027) were significant predictors for the development of major complications after lung cancer surgery.

Age over 80 years was not found to be an independent risk factor for the complication rates after lung cancer surgery. However, ECOG performance status ≥ 1, reduced FEV1/FVC, and lower serum albumin levels were independently associated with major postoperative complications.