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Pulmonary resection for lung cancer in octogenarians
S Pagni1, J A Federico, R B Ponn
1Division of Cardiothoracic Surgery, Hospital of St. Raphael, New Haven, Connecticut, USA.
The Annals of Thoracic Surgery
|March 1, 1997
Summary
Pulmonary resection for lung cancer in octogenarians is safe and effective, especially for stage I disease. Careful patient selection is key to minimizing risks and achieving good long-term survival outcomes in this age group.
Area of Science:
- Thoracic surgery
- Geriatric oncology
- Pulmonary medicine
Background:
- Octogenarians frequently present with resectable lung cancer.
- Concerns exist regarding the safety and applicability of surgical intervention in this elderly population due to reported high mortality rates.
Purpose of the Study:
- To evaluate the short-term and long-term outcomes of pulmonary resection for lung cancer in patients aged 80 years and older.
- To assess the safety and efficacy of surgical treatment in octogenarian lung cancer patients.
Main Methods:
- Retrospective review of 54 octogenarian patients who underwent pulmonary resection for lung cancer between 1980 and 1995.
- Surgical approach favored lobectomy; pneumonectomy was generally avoided in this age group.
Main Results:
- The perioperative mortality rate was low at 3.7% (2 deaths).
- The overall nonfatal complication rate was 42%, with major complications at 11%.
- Actuarial survival rates at 1, 3, and 5 years were 86%, 62%, and 43% for all discharged patients, and higher for stage I cases (97%, 78%, 57%).
Conclusions:
- Advanced age alone is not a contraindication for curative lung cancer resection in healthy octogenarians with stage I disease.
- Proper patient selection can lead to low acute risks.
- Extensive resections or operations for advanced stages (II/III) should be reserved for exceptional cases.