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Eur J Cardiothorac Surg 2005;28:380-383
© 2005 Elsevier Science NL

Original articles

Complications and outcomes after pulmonary resection for cancer in patients 80 to 89 years of age

^a Department of Surgery, Hyogo Prefectural Kaibara Hospital, Kaibara 5208-1, Kaibara-cho, Tanba city, Hyogo 669-3395, Japan
^b Department of Thoracic Surgery, Hyogo Medical Center for Adults, Akashi city, Hyogo, Japan

Received 2 May 2005; received in revised form 13 June 2005; accepted 15 June 2005.

^* Corresponding author. Tel.: +81 795 72 0524; fax: +81 795 72 1276. (Email: hmatsuoka1{at}mac.com).

Abstract

Objective: Patients 80 years or older often present with potentially resectable cases of non-small cell lung cancer. Whether such patients should undergo surgical treatment is becoming increasingly important in this rapidly aging society. Methods: From April 1997 through March 2004, 40 consecutive patients with non-small cell lung cancer who were 80–88 years of age underwent complete resection of their tumors, as confirmed pathologically. We reviewed preoperative data including gender, age, history of smoking, pulmonary function, co-morbidity, and induction/adjuvant therapy. Perioperative data consisted of surgical procedure, operative morbidity and mortality, histopathologic type, pathologic stage, and outcome. Results: The procedures comprised 16 lobectomies (40%), 12 segmentectomies (30%), and 12 wedge resections (30%). The histopathologic diagnosis was adenocarcinoma in 22 patients, squamous cell carcinomas in 11, large cell carcinomas in 4, adenosquamous cell carcinomas in 2, and neuro-endocrine cell carcinoma in 1. The disease stage was IA in 21 patients, IB in 14, IIB in 3, and IIIA in 2. There was no perioperative mortality. Eight patients had non-lethal complications (20%), including five with cardiopulmonary complications (parenchymal air leaks persisting for more than 7 days in two patients, interstitial pneumonia in one, bacterial pneumonia in one, and moderate arrhythmias in one) and three with minor complications (depression or confusion). The actuarial survival rates of the 40 patients, including deaths from all causes, were 92.4, 71.6, and 56.9% at 1, 3, and 5 years, respectively. In patients with stage I disease, the respective survival rates were 94.3, 74.3, and 57.3%. Conclusions: Advanced age is not a contraindication to curative resection in patients 80–89 years of age with stage I non-small cell lung cancer.

Key Words: Lung cancer • Elderly patients • Operation

Abbreviations: FEV1 = Forced expiratory volume per one second

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