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European Journal of Cardio-Thoracic Surgery, Vol 8, 453-456, Copyright © 1994 by European Association for Cardio-thoracic Surgery
KS Naunheim, KA Kesler, SA D'Orazio, AC Fiore and DR Judd
From 1981 through 1991, 40 patients 80 years of age or older underwent
thoracotomy for curative resection of bronchogenic carcinoma. There were 22
males and 18 females with a mean age of 82.7 years (range 80- 88). In three
patients, the operation was aborted due to unexpected metastatic disease
discovered at the time of thoracotomy. The remaining 37 patients underwent
5 pneumonectomies, 26 lobectomies and 6 segmentectomies or wedge
resections. Three of these patients (1 pneumonectomy, 1 lobectomy, and 1
wedge resection) underwent concomitant en bloc chest wall resection. The
overall operative mortality rate (in hospital or within 30 days) was 15%
(6/40) while there was a 16% mortality rate (6/37) for resected patients.
Complications occurred in 18 of 40 patients (45%) but were major in only 12
(30%). Major complications included respiratory insufficiency (6),
pneumonia (4), prolonged air leak (2), stroke (1), urinary retention
prostatectomy (1), and one unexplained sudden death 2 weeks following
discharge. Postoperative stay in the 34 operative survivors averaged 14 +/-
8.8 days (range 3-47). Univariate analysis revealed that neither gender,
extent of lung resection, preoperative NYHA class, history of heart disease
nor chronic obstructive pulmonary disease (COPD) were predictive of
operative mortality in the 37 patients undergoing lung resection. Age was
the only predictor of mortality (survivors 82.2 +/- 2.2, non-survivors 84.3
+/- 2.6; P < 0.05). The need for chest wall resection approached but did
not quite achieve significance (P < 0.08). Actuarial survival for all 40
patients at 1 and 3 years is 55% and 40%, respectively.(ABSTRACT TRUNCATED
AT 250 WORDS)
ARTICLES
Lung cancer surgery in the octogenarian
Department of Surgery, St. Louis University Medical Center, MO 63110- 0250.
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