Elsevier

Lung Cancer

Volume 23, Issue 2, February 1999, Pages 129-133
Lung Cancer

Results of surgical treatment of lung cancer in octogenarians

https://doi.org/10.1016/S0169-5002(99)00006-9Get rights and content

Abstract

The treatment of potentially resectable lung cancer in octogenarians has become a frequent clinical problem, due to the increasing number of elderly people maintaining an active daily life. In the present study, we reviewed the clinical records of patients to evaluate the results of the surgical treatment of lung cancer in octogenarians. From 1992 to 1995, 18 patients aged 80 years or older (octogenarians) with primary lung cancer underwent surgical resections including: three (16.7%) sleeve lobectomies, nine (50.0%) lobectomies, one (5.5%) segmentectomy, and five (27.8%) partial resections. The postoperative complication rate was 50% in octogenarians; however, no fatal complications were observed. The 5-year survival rate was 42.6%, which was similar to that obtained in younger patients. Based on our findings, the surgical treatment of lung cancer can thus be performed in selected octogenarians without increasing either morbidity or mortality, while also obtaining long-term survival.

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.

Section snippets

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

References (16)

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