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Thoracic cancer surgery in the elderly

J Hasse1, H Wertzel, M Kassa

  • 1Department of Thoracic Surgery, University Hospital of Freiburg, Germany.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|November 4, 1998
PubMed
Summary

Thoracic cancer surgery in patients aged 75 and older is safe with careful patient selection. This study found a 4.8% mortality rate, emphasizing restrictive indications for advanced disease.

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Area of Science:

  • Thoracic Surgery
  • Geriatric Oncology
  • Surgical Outcomes

Background:

  • Advanced age presents unique challenges for thoracic cancer surgery.
  • Assessing the safety and outcomes of thoracic cancer surgery in elderly patients (≥75 years) is crucial.

Purpose of the Study:

  • To analyze the risks and outcomes of thoracic cancer surgery in patients aged 75 years and older.
  • To determine the safety of these procedures and identify factors influencing mortality.

Main Methods:

  • Retrospective review of 119 consecutive patients aged 75+ undergoing thoracic cancer surgery between August 1986 and May 1998.
  • Analysis included patient demographics, tumor types (bronchial carcinoma, metastases, mesothelioma, etc.), and perioperative mortality.

Main Results:

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  • A total of 124 operations were performed on 119 patients (median age 77 years; range 75-87).
  • Overall 30-day or in-hospital mortality was 4.8% (6 fatalities), with 6.8% mortality in the bronchial carcinoma subgroup.
  • Causes of death included surgical complications and refractory heart failure post-complex procedures.

Conclusions:

  • Thoracic cancer surgery in elderly patients (≥75 years) can be safe when appropriate patient selection criteria are applied.
  • Indications for surgery, particularly for advanced cancers or pneumonectomy, should be approached with caution and restrictiveness.