INTRODUCTION: As the population ages, the age of patients undergoing thoracic surgery increases, and elderly patients often have more comorbidities than younger patients. METHODS: This retrospective study observed preoperative comorbidities, surgical procedures and postoperative morbidity and mortality after lung cancer surgery in patients 80 years of age or older. The medical records of lung cancer patients 80 years of age or older who underwent surgery from January 2003 to December 2012 were reviewed. RESULTS: There were 49 patients (27 males, 22 females), with a median age of 83 years. Thirty patients underwent major pulmonary resection and 18 patients underwent limited pulmonary resection. The median Charlson comorbidity index was 3. Although approximately two-thirds of the patients (20 patients; 40.8%) experienced some kind of postoperative morbidity, more than 80% of the complications were grade 1 or 2 according to the Clavien-Dindo classification. Cerebrovascular disease and chronic obstructive pulmonary disease were significantly associated with moderate-to-severe complications. Postoperative death was observed in two cases (4.1%). In addition, an increased American Society of Anesthesiologists classification score and past history of myocardial infarction, congestive heart failure and/or diabetes mellitus with end-organ damage were significantly associated with mortality. The overall survival rate was 79.6% at 3 years and 53.1% at 5 years. CONCLUSIONS: Thoracic surgery shows acceptable morbidity and mortality in patients 80 years of age or older. Patients 80 years of age or older should be offered the best treatments, including surgery, with careful patient evaluation and selection.
INTRODUCTION: As the population ages, the age of patients undergoing thoracic surgery increases, and elderly patients often have more comorbidities than younger patients. METHODS: This retrospective study observed preoperative comorbidities, surgical procedures and postoperative morbidity and mortality after lung cancer surgery in patients 80 years of age or older. The medical records of lung cancerpatients 80 years of age or older who underwent surgery from January 2003 to December 2012 were reviewed. RESULTS: There were 49 patients (27 males, 22 females), with a median age of 83 years. Thirty patients underwent major pulmonary resection and 18 patients underwent limited pulmonary resection. The median Charlson comorbidity index was 3. Although approximately two-thirds of the patients (20 patients; 40.8%) experienced some kind of postoperative morbidity, more than 80% of the complications were grade 1 or 2 according to the Clavien-Dindo classification. Cerebrovascular disease and chronic obstructive pulmonary disease were significantly associated with moderate-to-severe complications. Postoperative death was observed in two cases (4.1%). In addition, an increased American Society of Anesthesiologists classification score and past history of myocardial infarction, congestive heart failure and/or diabetes mellitus with end-organ damage were significantly associated with mortality. The overall survival rate was 79.6% at 3 years and 53.1% at 5 years. CONCLUSIONS: Thoracic surgery shows acceptable morbidity and mortality in patients 80 years of age or older. Patients 80 years of age or older should be offered the best treatments, including surgery, with careful patient evaluation and selection.
Authors: Sunny Wang; Melisa L Wong; Nathan Hamilton; J Ben Davoren; Thierry M Jahan; Louise C Walter Journal: J Clin Oncol Date: 2012-03-26 Impact factor: 44.544
Authors: Mark F Berry; Jennifer Hanna; Betty C Tong; William R Burfeind; David H Harpole; Thomas A D'Amico; Mark W Onaitis Journal: Ann Thorac Surg Date: 2009-10 Impact factor: 4.330
Authors: Malcolm V Brock; Min P Kim; Craig M Hooker; Anthony J Alberg; Margaret M Jordan; Carmen M Roig; Li Xu; Stephen C Yang Journal: Ann Thorac Surg Date: 2004-01 Impact factor: 4.330
Authors: Jeffrey L Port; Michael Kent; Robert J Korst; Paul C Lee; Matthew A Levin; Douglas Flieder; Nasser K Altorki Journal: Chest Date: 2004-09 Impact factor: 9.410
Authors: Annemarie F Shepherd; Michelle Iocolano; Jonathan Leeman; Brandon S Imber; Aaron T Wild; Michael Offin; Jamie E Chaft; James Huang; Andreas Rimner; Abraham J Wu; Daphna Y Gelblum; Narek Shaverdian; Charles B Simone; Daniel R Gomez; Ellen D Yorke; Andrew Jackson Journal: Pract Radiat Oncol Date: 2020-10-14
Authors: Nam P Nguyen; Juan Godinez; Wei Shen; Vincent Vinh-Hung; Helena Gorobets; Juliette Thariat; Fred Ampil; Jacqueline Vock; Ulf Karlsson; Alexander Chi Journal: Medicine (Baltimore) Date: 2016-10 Impact factor: 1.889