HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (6) Citing Articles via Google Scholar Google Scholar Articles by Sawada, S. Articles by Yamashita, M. Search for Related Content PubMed PubMed Citation Articles by Sawada, S. Articles by Yamashita, M.

Advanced Age Is Not Correlated With Either Short-term or Long-term Postoperative Results in Lung Cancer Patients In Good Clinical Condition^*

^* From the Departments of Thoracic Surgery (Drs. Sawada, Komori, and Yamashita) and Medical Oncology (Drs. Nogami, Bessho, Segawa, and Shinkai), National Hospital Organization Shikoku Cancer Center, Ehime; and Division of Thoracic and Cardiovascular Surgery (Dr. Nakata), Kawasaki Medical School, Kawasaki, Japan.

Correspondence to: Shigeki Sawada, MD, PhD, Department of Thoracic Surgery, Shikoku Cancer Center, Horinouchi 13, Matsuyama, Ehime, 790-0007, Japan

Objectives: Several investigators have reported that operative mortality in the elderly is acceptable. However, their patients are potentially biased with regard to some factors such as performance status (PS) and comorbidity. In this study, we discuss surgical indications for the elderly and effects on perioperative mortality and prognosis.

Study design: A retrospective study was carried out by reviewing the records of 1,114 patients who were referred for treatment of non-small cell lung cancer between January 1993 and December 2002. The patients were classified into younger ( 75 years of age) and elderly ( 76 years of age) groups. The histologic subtype, TNM stage, Eastern Cooperative Oncology Group PS, and treatment were reviewed for members of each group, and the proportion of patients who underwent surgery was compared between the two groups. The surgical procedures, perioperative mortality, and prognosis of the two groups were also compared.

Results: There was a significant difference in the histologic distribution with no difference in TNM staging between the two groups. Regarding treatment, 51.0% of those in the younger group and 36.1% of those in the elderly group underwent surgery. The proportion of elderly patients who underwent surgery was significantly lower than that of the younger patients, mainly due to worse PS and comorbidity in the elderly patients. The perioperative mortality rates for the younger and elderly groups were 0.9% and 4.1%, respectively, with no significant difference, and the overall survival was similar between the two groups.

Conclusions: When compared to younger patients, fewer elderly patients underwent surgery because of worse PS and comorbidity. However, in elderly patients with good PS and no comorbidity, the rate of perioperative mortality and the prognosis were similar to those in the younger patients. Therefore, advanced age only is not a negative factor for surgery in elderly patients.

Key Words: elderly • limited resection • lobectomy • mortality • non-small cell lung cancer • performance status • prognosis

This article has been cited by other articles:

				A. Dulu, S. M. Pastores, B. Park, E. Riedel, V. Rusch, and N. A. Halpern Prevalence and Mortality of Acute Lung Injury and ARDS After Lung Resection. Chest, July 1, 2006; 130(1): 73 - 78. [Abstract] [Full Text] [PDF]