Results of surgical treatment of lung cancer in octogenarians
Introduction
Lung cancer has recently become the leading cause of death among cancer patients, especially in Japanese men [1], [2]. The necessity of surgical treatment for elderly lung cancer patients is also increasing, because of the prolonged life span of the Japanese: the projected life-expectancy for people aged 80 years old in Japan has recently been reported to be 7.1 and 9.5 years for men and women, respectively [3]. The treatment of potentially resectable lung cancer in octogenarians has thus become a frequent clinical problem. Because a surgical resection is still the only potentially curative form of treatment, we perform surgery whenever feasible, if no distant metastasis is observed [4], [5]. However, a careful decision regarding the operative indications and selection of adequate operative procedures is required in order not to reduce the quality of life in octogenarians. In the present study, we reviewed our recent cases to evaluate the results of surgical treatment of lung cancer in octogenarians.
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Patients and methods
From 1992 to 1995, 18 patients aged 80 years or older (octogenarians) underwent surgical resection for primary lung cancer at the Kitakyushu Municipal Medical Center. During this period, 290 patients with primary lung cancer were surgically treated. From 1992, the records of 100 consecutive patients aged less than 80 years were retrospectively reviewed as the control group. The patients records were retrieved, and the clinical data, preoperative investigation, operative details, and
Results
Of the 290 patients surgically treated, 18 (6.2%) were 80 years or older and consisted of 11 men and seven women whose ages ranged from 80 to 87 years (mean age: 82.1 years). The control group consisted of 77 men and 33 women. The age of the patients in the control group ranged from 17 to 78 (mean age: 63.0 years).
Among the octogenarians eight patients had adenocarcinomas, eight had squamous cell carcinomas, one had large cell carcinoma and one had adenosquamous carcinoma. There were no
Discussion
As the population continues to age, the proportion of older patients leading active and independent lives is increasing. For thoracic surgeons, determining the optimal methods to treat the growing number of elderly patients with potentially resectable lung cancer is a frequent clinical problem. It is well known that advanced age increases the risks of operative morbidity and mortality for most major surgical procedures [6], [7], [8]. However, several authors have reported that surgical
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2016, Revue de Pneumologie CliniqueMorbidity and mortality in octogenarians with lung cancer undergoing pneumonectomy
2015, Archivos de BronconeumologiaCitation Excerpt :For others, long-term survival is of less importance than relief of symptoms and maintaining a quality of life similar to that experienced before the procedure.8 Although the prevalence of postoperative complications in our series was around 13%, in most other studies, 20%–60% of patients over 80 years had 1 or more postoperative complication, mainly cardiorespiratory events.9–12 This factor must be taken into account when discussing different treatment options with octogenarian patients, since many may choose a less invasive approach.13
Stereotactic ablative body radiation therapy for octogenarians with non-small cell lung cancer
2013, International Journal of Radiation Oncology Biology PhysicsCitation Excerpt :The morbidity and mortality rates after surgical treatment for elderly patients are reported to be 18%-45% and 0%-15% (10), respectively. Therefore, it is emphasized that only physically fit octogenarians should be selected for resection (4, 5) and that more severe criteria for octogenarians should be used, compared with those for younger patients. Regarding outcomes for octogenarians with stage I NSCLC after careful evaluation and selection, 5-year survival rates after surgery were reported to be 34%-79% (1-5).
Are we treating enough elderly patients with early stage non-small cell lung cancer?
2011, Lung CancerCitation Excerpt :However, several studies support that surgical treatment of NSCLC in the elderly is feasible and that age itself is not a contraindication for surgical intervention [25,27–43], even in octogenarians [44–51]. Moreover, studies comparing outcomes between younger and older age groups have not demonstrated a significant difference in overall survival [21,34,36–38,45], or in the patient's post-operative functional status [39]. Furthermore, studies that reported higher overall survival for younger patients demonstrated that elderly patient groups had similar disease-specific survival [32] and recurrence rate [43].
Stereotactic body radiotherapy using real-time tumor tracking in octogenarians with non-small cell lung cancer
2010, Lung CancerCitation Excerpt :Mortality rates in octogenarians have been reduced from 30% in the sixties [37] to current rates just below 2% for limited pulmonary resections [38]. Despite this, the risk of mortality still increases with each decade of life [33,38,39] and reported rates of mortality in octogenarians still vary enormously (0–15%) [8,10,12,13,38]. Variations in these mortality rates are caused by small study sizes, differences in hospital treatment volumes and the extent of lung surgery.