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Habbous S, Alibhai SMH, Menjak IB, Forster K, Holloway CMB, Darling G. The effect of age on the opportunity to receive cancer treatment. Cancer Epidemiol 2022; 81:102271. [PMID: 36209661 DOI: 10.1016/j.canep.2022.102271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Older adults with cancer may not receive the same opportunities for treatment as younger patients. In this retrospective population-based cohort study, we explored whether age was an independent predictor of receiving specialist consultation and treatment. METHODS Patients age 45-99 were identified from the Ontario Cancer Registry having a primary solid tumor diagnosed between 01/Jan/2010 and 31/Dec/2019. We used logistic regression adjusted sociodemographic and clinical characteristics to compare the likelihood of consultation or receipt of treatment using linear splines at critical ages of 65, 80, and 90 years. RESULTS A total 168,232 (42%), 165,205 (41%), 57,360 (14%), and 7810 (2%) patients were diagnosed age 45-64, 65-79, 80-89, and 90-99, respectively. The likelihood of surgical consultation decreased as patients reached 65 years [adjusted odds ratio (aOR) 0.86 (0.84-0.89)], which decreased further among octogenarians [aOR 0.63 (0.59-0.67)]. Similar results were observed for consultation with a medical oncologist and radiation oncologist. Receipt of surgery also decreased with age. Three-month post-operative mortality was higher among older patients [aRR 1.38 (1.26-1.50) per 10 years, p < 0.0001], an effect that remained similar as patients reached age 65 + years of age (p = 0.09 for change). For stage I patients, 3-month post-operative survival was high across all age groups, ranging from 99.8% in 45-64 year-olds, 99.4% in 65-79 year-olds, and 98.1% among octogenarians and nonagenarians (lung, colorectal, breast, cervical cancer patients). CONCLUSION Older patients were less likely to have specialist consultations. More comprehensive data collection on clinical factors and referral patterns is needed to improve care for elderly cancer patients.
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Affiliation(s)
- Steven Habbous
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, Ontario, Canada; Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
| | - Shabbir M H Alibhai
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Ines B Menjak
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Medical Oncology & Hematology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Katharina Forster
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, Ontario, Canada
| | - Claire M B Holloway
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Gail Darling
- Ontario Health (Cancer Care Ontario), 525 University Ave, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Thoracic Surgery, Toronto General Hospital, Toronto, Ontario, Canada
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Lou X, Sanders A, Wagh K, Binongo JN, Sancheti M, Javidfar J, Pickens A, Fernandez F, Force S, Khullar O. Safety and Feasibility of Thoracoscopic Lung Resection for Non-Small-Cell Lung Cancer in Octogenarians. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2020; 16:68-74. [PMID: 33245249 DOI: 10.1177/1556984520971620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Octogenarians comprise an increasing proportion of patients presenting with non-small-cell lung cancer (NSCLC). This study examines postoperative morbidity and mortality, and long-term survival in octogenarians undergoing thoracoscopic anatomic lung resection for NSCLC, compared with younger cohorts. METHODS We conducted a retrospective review of our institutional Society of Thoracic Surgeons General Thoracic Surgery Database of all patients ≥60 years old undergoing elective lobectomy or segmentectomy for pathologic stage I, II, and IIIA NSCLC between 2009 and 2018. Results were compared between octogenarians (n = 71) to 2 younger cohorts of 60- to 69-year-olds (n = 359) and 70- to 79-year-olds (n = 308). Long-term survival among octogenarians was graphically summarized using the Kaplan-Meier method. Cox regression analysis was used to identify preoperative risk factors for mortality. RESULTS A greater proportion of octogenarians required intensive care unit admission and discharge to extended-care facilities; however, postoperative length of stay was similar between groups. Among postoperative complications, arrhythmia and renal failure were more likely in the older cohort. Compared to the youngest cohort, in-hospital and 30-day mortality were highest among octogenarians. Overall survival among octogenarians at 1, 3, and 5 years was 87.3%, 61.8%, and 50.5%, respectively. On multivariable Cox regression analysis of baseline demographic variables, presence of stroke (hazard ratio [HR] = 28.5, 95% confidence interval [CI]: 6.1 to 132.7, P < 0.001) and coronary artery disease (HR = 2.5, 95% CI: 1.2 to 5.3, P = 0.02) were significant predictors of overall mortality among octogenarians. CONCLUSIONS Thoracoscopic resection can be performed with favorable early postoperative outcomes among octogenarians. Long-term survival, although comparable to their healthy peers, is worse than those of younger cohorts. Further study into preoperative risk stratification and alternative therapies among octogenarians is needed.
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Affiliation(s)
- Xiaoying Lou
- 1371 Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Andrew Sanders
- 1371 Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Kaustubh Wagh
- 1859 Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jose N Binongo
- 1859 Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Manu Sancheti
- 1371 Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeffrey Javidfar
- 1371 Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Allan Pickens
- 1371 Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Felix Fernandez
- 1371 Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Seth Force
- 1371 Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Onkar Khullar
- 1371 Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, GA, USA
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Tantraworasin A, Siwachat S, Tanatip N, Lertprasertsuke N, Kongkarnka S, Euathrongchit J, Wannasopha Y, Suksombooncharoen T, Chewaskulyong B, Taioli E, Saeteng S. Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old. Asian J Surg 2019; 43:154-165. [PMID: 30898491 DOI: 10.1016/j.asjsur.2019.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/23/2019] [Accepted: 03/05/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND An appropriate treatment of older lung cancer patients has become an important issue. The aim of this study is to evaluate the short and long-term surgical outcomes in lung cancer patients using 70 years as a cut-point, and to identify prognostic factors of cancer-specific mortality in patients older than 70 years. METHODS Medical records of non-small cell lung cancer (NSCLC) patients who underwent pulmonary resection at Chiang Mai University Hospital from January 2002 through December 2016 were retrospectively reviewed. Patients were divided into age less than 70 years (control group) and 70 years or more (study group). Primary outcomes were major post-operative complications and in-hospital death (POM); secondary outcome was long-term survival. Multivariable regression analysis was used. RESULTS This study included 583 patients, 167 for study group, and 416 for control group. There were no differences in POM, both at univariable and multivariable analyses, however, for long-term cancer-specific mortality, the study group was more likely to die (HRadj = 1.40, 95%CI = 1.03-1.89). Adverse prognostic factors for long-term mortality in study group were having universal coverage scheme (HRadj = 1.70, 95%CI = 1.03-2.79), the presence of intratumoral lymphatic invasion (HRadj = 2.83, 95%CI = 1.28-6.29), perineural invasion (HRadj = 2.80, 95%CI = 1.13-6.94), underwent lymph node sampling (HRadj = 2.23, 95%CI = 1.16-4.30) and higher stage of disease (HRadj = 2.02, 95%CI = 1.06-3.85 for stage III, HRadj = 3.40, 95%CI = 1.29-8.94 for stage IV). CONCLUSIONS In-hospital mortality and composite post-operative complications are acceptable in pulmonary resection for NSCLC patients older than 70 years. However, these patients had shorter long-term survival, especially who have some adverse prognostic factors. Further studies with larger sample size are warranted.
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Affiliation(s)
- Apichat Tantraworasin
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand; Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Sophon Siwachat
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Narumon Tanatip
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nirush Lertprasertsuke
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sarawut Kongkarnka
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Juntima Euathrongchit
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Yutthaphan Wannasopha
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Busayamas Chewaskulyong
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Emanuela Taioli
- Tisch Cancer Institute, Institute for Translational Epidemiology, Department of Population Health Science and Policy, Icahn Medical School at Mount Sinai, New York, NY, USA
| | - Somcharoen Saeteng
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Vazirani J, Moraes J, Barnett S, Johnson DF, Knight S, Miller A, Wright G, Alam NZ, Conron M, Irving LB, Antippa P, Steinfort DP. Outcomes following resection of non-small cell lung cancer in octogenarians. ANZ J Surg 2018; 88:1322-1327. [DOI: 10.1111/ans.14861] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 08/04/2018] [Accepted: 08/06/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Jaideep Vazirani
- Department of Respiratory and Sleep Medicine; The Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Johanna Moraes
- Department of Respiratory and Sleep Medicine; The Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Stephen Barnett
- Department of Cardiothoracic Surgery; The Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Thoracic Surgery; Austin Hospital; Melbourne Victoria Australia
- Division of Cancer Surgery; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
- Department of Surgery; The University of Melbourne; Melbourne Victoria Australia
| | - Douglas F. Johnson
- Department of Medicine; The Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Medicine; University of Melbourne; Melbourne Victoria Australia
| | - Simon Knight
- Department of Thoracic Surgery; Austin Hospital; Melbourne Victoria Australia
- Department of Surgery; The University of Melbourne; Melbourne Victoria Australia
| | - Alistair Miller
- Department of Respiratory and Sleep Medicine; Monash Health; Melbourne Victoria Australia
| | - Gavin Wright
- Department of Cardiothoracic Surgery; The Royal Melbourne Hospital; Melbourne Victoria Australia
- Division of Cancer Surgery; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
- Department of Surgery; The University of Melbourne; Melbourne Victoria Australia
- Department of Cardiothoracic Surgery; St Vincent's Hospital; Melbourne Victoria Australia
| | - Naveed Z. Alam
- Department of Surgery; The University of Melbourne; Melbourne Victoria Australia
- Department of Cardiothoracic Surgery; St Vincent's Hospital; Melbourne Victoria Australia
| | - Matthew Conron
- Department of Respiratory and Sleep Medicine; St Vincent's Hospital; Melbourne Victoria Australia
- Department of Cancer Medicine; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - Louis B. Irving
- Department of Respiratory and Sleep Medicine; The Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Medicine; University of Melbourne; Melbourne Victoria Australia
- Department of Cancer Medicine; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
| | - Phillip Antippa
- Department of Cardiothoracic Surgery; The Royal Melbourne Hospital; Melbourne Victoria Australia
- Division of Cancer Surgery; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
- Department of Surgery; The University of Melbourne; Melbourne Victoria Australia
| | - Daniel P. Steinfort
- Department of Respiratory and Sleep Medicine; The Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Medicine; University of Melbourne; Melbourne Victoria Australia
- Department of Cancer Medicine; Peter MacCallum Cancer Centre; Melbourne Victoria Australia
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Significance of Body Mass Index for Postoperative Outcomes after Lung Cancer Surgery in Elderly Patients. World J Surg 2017; 42:153-160. [DOI: 10.1007/s00268-017-4142-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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High Risk for Thoracotomy but not Thoracoscopic Lobectomy. Ann Thorac Surg 2017; 103:1730-1735. [PMID: 28262299 DOI: 10.1016/j.athoracsur.2016.11.076] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 09/21/2016] [Accepted: 11/28/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Pulmonary lobectomy is the standard of care for resection of non-small cell lung cancer (NSCLC). Patients with compromised lung function who are considered high risk may be denied surgical treatment; thus, proper identification of those truly at high risk is critical. Video-assisted thoracic surgery (VATS) may reduce the operative risk. This study reviews our institutional experience of pulmonary lobectomy by open thoracotomy or VATS techniques in patients deemed to be high risk. METHODS A retrospective review of an institutional database was performed for all patients undergoing lobectomy from 2002 to 2010. Patients were grouped into high-risk (HR) and standard-risk (SR) cohorts according to the American College of Surgeons Oncology Group Z4099/Radiation Therapy Oncology Group 1021 criteria. RESULTS From 2002 to 2010, 72 HR and 536 SR patients underwent lobectomy. Mean age was 73 years for HR and 66 years for SR (p < 0.0001). Rates of overall (p < 0.0001) and pulmonary complications (p < 0.0001) were significantly higher in the HR group. However, when HR patients were resected by VATS, there was no significant difference in overall (p = 0.1299) or pulmonary complications (p = 0.2292) compared with the SR VATS group. Moreover, overall survival was significantly lower for HR patients who had an open operation compared with VATS lobectomy or SR open (p = 0.0028). CONCLUSIONS VATS lobectomy offers patients who are considered to be at increased risk for open lobectomy a feasible procedure, with no difference in overall survival compared with SR patients, and decreased morbidity compared with open lobectomy. VATS lobectomy should be considered for patients who historically may not have been considered for surgical resection.
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Lee PC, Kamel M, Nasar A, Ghaly G, Port JL, Paul S, Stiles BM, Andrews WG, Altorki NK. Lobectomy for Non-Small Cell Lung Cancer by Video-Assisted Thoracic Surgery: Effects of Cumulative Institutional Experience on Adequacy of Lymphadenectomy. Ann Thorac Surg 2016; 101:1116-22. [DOI: 10.1016/j.athoracsur.2015.09.073] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/10/2015] [Accepted: 09/21/2015] [Indexed: 11/30/2022]
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Abstract
PURPOSE OF REVIEW The role of limited, sublobar resection in patients with early-stage nonsmall cell lung cancer (NSCLC) remains controversial. Alternative treatments for surgical resection include stereotactic radiotherapy and radiofrequency ablation. In this review, the role of limited resection is discussed in patients presenting a s high-risk for s surgical intervention. RECENT FINDINGS Clear definitions of high-risk patients are currently lacking, as well as, randomized prospective studies indicating which treatment to offer in this population. Awaiting results of two major ongoing trials, at this moment the decision-making process is heavily dependent on retrospective analyses. For selected patients sublobar resection may be a valid oncological option for clinical stage IA NSCLC. SUMMARY Surgery remains the gold standard for NSCLC. In case of high-risk patients, a multidisciplinary consultation should advise the patient which treatment option to choose. In early-stage NSCLC, sublobar anatomical resection is preferred over nonsurgical procedures to determine nodal status and prognosis. In case of patients unfit for surgery, stereotactic radiotherapy is a good alternative. A randomized prospective study is necessary to determine survival in high-risk patients allocated to surgery (lobectomy or sublobar resection) or radiation-based treatment.
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Miura N, Kohno M, Ito K, Senba M, Kajiwara K, Hamaguchi N, Makino H, Kanematsu T, Okamoto T, Yokoyama H. Lung cancer surgery in patients aged 80 years or older: an analysis of risk factors, morbidity, and mortality. Gen Thorac Cardiovasc Surg 2015; 63:401-5. [PMID: 25868520 DOI: 10.1007/s11748-015-0546-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/25/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION As the population ages, the age of patients undergoing thoracic surgery increases, and elderly patients often have more comorbidities than younger patients. METHODS This retrospective study observed preoperative comorbidities, surgical procedures and postoperative morbidity and mortality after lung cancer surgery in patients 80 years of age or older. The medical records of lung cancer patients 80 years of age or older who underwent surgery from January 2003 to December 2012 were reviewed. RESULTS There were 49 patients (27 males, 22 females), with a median age of 83 years. Thirty patients underwent major pulmonary resection and 18 patients underwent limited pulmonary resection. The median Charlson comorbidity index was 3. Although approximately two-thirds of the patients (20 patients; 40.8%) experienced some kind of postoperative morbidity, more than 80% of the complications were grade 1 or 2 according to the Clavien-Dindo classification. Cerebrovascular disease and chronic obstructive pulmonary disease were significantly associated with moderate-to-severe complications. Postoperative death was observed in two cases (4.1%). In addition, an increased American Society of Anesthesiologists classification score and past history of myocardial infarction, congestive heart failure and/or diabetes mellitus with end-organ damage were significantly associated with mortality. The overall survival rate was 79.6% at 3 years and 53.1% at 5 years. CONCLUSIONS Thoracic surgery shows acceptable morbidity and mortality in patients 80 years of age or older. Patients 80 years of age or older should be offered the best treatments, including surgery, with careful patient evaluation and selection.
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Affiliation(s)
- Naoko Miura
- Department of Surgery, Saiseikai Karatsu Hospital, 817, Motohata-machi, Karatsu, Saga, 847-0052, Japan,
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Freixinet Gilart J, Rodríguez Suárez PM. Morbidity, mortality and survival after surgery for lung cancer. Arch Bronconeumol 2015; 51:211-2. [PMID: 25857573 DOI: 10.1016/j.arbres.2015.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 01/28/2015] [Accepted: 02/10/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Jorge Freixinet Gilart
- Hospital Universitario de Gran Canaria Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Isla de Gran Canaria, España.
| | - Pedro Miguel Rodríguez Suárez
- Hospital Universitario de Gran Canaria Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Isla de Gran Canaria, España
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Hino H, Murakawa T, Ichinose J, Nagayama K, Nitadori J, Anraku M, Nakajima J. Results of Lung Cancer Surgery for Octogenarians. Ann Thorac Cardiovasc Surg 2015; 21:209-16. [PMID: 25740447 DOI: 10.5761/atcs.oa.14-00160] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Growing number of elderly lung cancer patients reflecting a lengthening life span has become a serious problem. Purpose of this study was to elucidate the short and long-term outcome of the surgery for octogenarians, and to evaluate the role of lung cancer surgery for this high age group. METHODS The patients with lung cancer aged 80 years or more who underwent the surgery at our institute from January 1998 through December 2012 were retrospectively analyzed by chart review, and the operative mortality, morbidity and the long-term survival were assessed. RESULTS Out of a total of 1107 patients with primary lung cancer who received surgery during the study period, 94 were octogenarians (8.5%). Sixty-nine patients (73.4%) had preoperative co-morbidity including hypertension in 50 (53.2%), coincidence of other malignancy in 35 (37.2%), anti-coagulant therapy in 29 (30.9%). Twenty-six patients (27.7%) had major or minor postoperative morbidity, and one (1.1%) died due to bronchopleural fistula. Overall-5-year survival rate was 57.5%. Univariative and multivariative analysis using Cox proportional hazard model revealed that male gender and non-adenocarcinoma histology were significant risk factors for poor prognosis. CONCLUSION Gender and histology should be taken into account in preoperative evaluation of indication for lung cancer in octogenarians.
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Affiliation(s)
- Haruaki Hino
- Department of Thoracic Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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