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Lung Resection in the Elderly

Harbor-UCLA Medical Center, Rancho Palos Verdes, CA

Correspondence to: Yossef Aelony, MD, FCCP, Clinical Professor of Medicine (Pulmonary), Harbor-UCLA, Rancho Palos Verdes, CA 90275; e-mail: y.aelony{at}cox.net

To the Editor:

The article by Mery et al in a recent issue of CHEST (July 2005)¹ is an important contribution indicating that minimal resection in patients with stage I and II lung cancer may be as effective in prolonging survival as more extensive surgery in the elderly.¹ The authors mention that Ginsberg et al² reported in 1983 that perioperative mortality in lung cancer patients increased from 1.3% in those patients < 59 years of age to 7% in those > 70 years of age. I was therefore disappointed that the current authors, with all the data in front of them from 14,555 resections, did not share with us an updated estimate of perioperative mortality in elderly patients who have undergone resection for early-stage cancer.

I hope the authors can provide us with these data, since the most up-to-date information is necessary to provide informed consent in all our preoperative visits.

References

1. Mery, CM, Pappas, AN, Bueno, R, et al (2005) Similar long-term survival of elderly patients with non-small cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database. Chest 128,237-245[Abstract/Free Full Text]
2. Ginsberg, RJ, Hill, LD, Eagan, RT, et al Modern thirty-day operative mortality for surgical resections in lung cancer. J Thorac Cadiovasc Surg 1983;86,654-658[Abstract]

Brigham and Women’s Hospital, Boston, MA

Correspondence to: Carlos M. Mery, MD, MPH, Stanford University, Department of Biodesign, James H. Clark Center, 318 Campus Dr, Room E100, Stanford, CA 94305; e-mail: cmery{at}stanford.edu

To the Editor:

We appreciate the comments by Dr Aelony. The 30-day postoperative mortality rate for patients who have undergone curative resections (ie, limited resections, lobectomies, and pneumonectomies) for treatment of stage I or II non-small cell lung cancer was 0.4% for patients < 65 years old, 0.6% for those 65 to 74 years old, and 1.2% for those 75 years old (p = 0.001). These differences appeared to be due mainly to differences in survival among patients undergoing lobectomies. The perioperative mortality rate after undergoing lobectomy was 0.3% for patients < 65 years old, 0.5% for those 65 to 74 years old, and 1.5% for the elderly (p < 0.0001). The difference in perioperative mortality rate between age groups was statistically similar for patients undergoing limited resection (0%, 0.5%, and 0%, respectively).

This Article 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 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 Google Scholar Google Scholar Articles by Aelony, Y. Articles by Jaklitsch, M. T. Search for Related Content PubMed PubMed Citation Articles by Aelony, Y. Articles by Jaklitsch, M. T.