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Eur J Cardiothorac Surg 2007;32:370-374. doi:10.1016/j.ejcts.2007.04.002
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Lung cancer in octogenarians: factors affecting long-term survival following resection

Division of General Thoracic Surgery, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905, United States

Received 13 September 2006; received in revised form 17 March 2007; accepted 2 April 2007.

^_* Corresponding author. Tel.: +1 507 266 0911; fax: +1 507 284 0058. (Email: cassivi.stephen{at}mayo.edu).

Objective: To identify factors associated with long-term survival following pulmonary resection for lung cancer in patients 80 years of age or older. Methods: The medical records of all patients 80 years, who underwent pulmonary resection for lung cancer from 1985 to 2002, were reviewed. Results: There were 294 patients (192 men, 102 women). Median age was 82 years (range 80–94 years). Overall 1-, 2-, and 5-year survival was 80%, 62%, and 34%, respectively. Histologic subtype, diabetes, renal insufficiency, prior myocardial infarction, congestive heart failure or stroke were not significantly associated with differences in 5-year survival. Female gender was associated with increased survival (36.2% vs 32.7% at 5 years, p = 0.04). Extent of preoperative forced expiratory volume in 1 s (FEV1) limitation did not influence survival. However, there were no 5-year survivors amongst patients with dyspnea as their presenting chief complaint, whereas there was a 35% 5-year survival in patients presenting without dyspnea (p < 0.001). Five-year survival by pathologic stage was IA, 48%; IB, 39%; IIA, 17%; IIB, 23%; IIIA, 9%; and IIIB, 0% (p < 0.001). Five-year survival of patients undergoing a lobectomy was 42% versus 11% for pneumonectomy (p < 0.001). Conclusions: Meaningful long-term survival is obtainable in elderly patients undergoing surgical resection for lung cancer. Careful patient evaluation and selection is necessary to identify patients who will benefit most from resection. Shorter survival was observed in male patients and those presenting with dyspnea. As could be expected, survival was also dependent on extent of resection and initial pathologic stage.

Key Words: Pulmonary resection • Lung cancer • Geriatric

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