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Multicenter Study
. 2013 Mar;16(3):250-6.
doi: 10.1093/icvts/ivs473. Epub 2012 Nov 23.

Early and long-term results of pulmonary resection for non-small-cell lung cancer in patients over 75 years of age: a multi-institutional study

Andrea Dell'Amore  1 , Marco Monteverde, Nicola Martucci, Stefano Sanna, Guido Caroli, Franco Stella, Davide Dell'Amore, Gaetano Rocco
Affiliations
Multicenter Study

Early and long-term results of pulmonary resection for non-small-cell lung cancer in patients over 75 years of age: a multi-institutional study

Andrea Dell'Amore et al. Interact Cardiovasc Thorac Surg. 2013 Mar.

Abstract

Objectives: Older lung cancer patients with multiple morbidities are increasingly referred to thoracic surgery departments. The aim of this multicenter study was to analyse the prognostic factors for in-hospital morbidity and mortality and to elucidate the predictors of long-term survival and oncological outcomes.

Methods: We identified 319 patients aged ≥ 75 years who underwent intended curative lung resection for lung cancer in three different thoracic surgery departments between January 2000 and December 2010.

Results: Seventy-one patients underwent limited resection, 202 had lobectomy, 16 had bilobectomy and 30 had pneumonectomy. The in-hospital mortality was 6.6%. Chronic renal failure, low respiratory reserve and pneumonectomy were predictors of in-hospital mortality. The mean follow-up time was 3.9 years, ranging from 1 month to 10.4 years. The disease-free survivals at 1, 3 and 5 years were 82, 60 and 47%, respectively. The overall survivals at 1, 3 and 5 years were 86, 59 and 38%, respectively. The long-term overall survival was negatively influenced by pneumonectomy, extended resection, N(1-2) subgroups and pathological TNM stage.

Conclusions: Nowadays, we can consider surgery a safe and justifiable option for elderly patients. Careful preoperative work-up and selection are mandatory to gain satisfactory results. Good long-term results were achieved in elderly patients with early stage who underwent lobar or sublobar lung resection. The role of surgery or other alternative therapies, in patients with advanced stages, extensive nodal involvement and/or requiring extensive surgical resection for curative intent, is still unclear and further studies are certainly needed.

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Figures

Figure 1:
Figure 1:
(a) Kaplan–Meier function of overall survival. (b) Kaplan–Meier function of disease-free survival.
Figure 2:
Figure 2:
(a) Kaplan–Meier overall survival stratified type of resection, (b) Kaplan–Meier overall survival stratified for extended resection.
Figure 3:
Figure 3:
(a) Kaplan–Meier overall survival stratified for N factors, (b) Kaplan–Meier overall survival stratified for pathological stage.
See this image and copyright information in PMC

References

    1. Pallis AG, Gridelli C, van Meerbeeck JP, Greillier L, Wedding U, Lacombe D, et al. EORTC Elderly Task Force and lung cancer group and International Society for Geriatric Oncology (SIOG) experts’ opinion for the treatment of non-small-cell lung cancer in an elderly population. Ann Onc. 2010;21:692–706. - PubMed
    1. Verdecchia A, Caldora M, Frova L. Mortality Rate for Cancer in Italy: New Trends of Evolution (years 1970–1999) Rome: Istituto Nazionale di Statistica (ISTAT); 2005. in Italian.
    1. Colice GL, Shafazand S, Griffin JP, Keenan R, Bollinger CT. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidence-based clinical practice guidelines (2nd edition) Chest. 2007;132:161–77. - PubMed
    1. Brunelli A, Charloux A, Bollinger CT, Rocco G, Sculier JP, Varela G, et al. The European Respiratory Society and European Society of Thoracic Surgeons clinical guidelines for evaluating fitness for radical treatment (surgery and chemoradiotherapy) in patients with lung cancer. Eur J Cardiothorac Surg. 2009;36:181–4. - PubMed
    1. Janssen F, Kunst AJ. The choice among past trends as a basis for the prediction of future trends in older age mortality. Popul Stud (Camb) 2007;61:315–26. - PubMed

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