Author of

• 11595

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  P2.07 - Poster Session 2 - Surgery (ID 190)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11616

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    P2.07-021 - Results of surgical treatment for lung cancer in patients aged 80 years or over - Single institution over 20 year experience (ID 1781)

    09:30 - 09:30  |  Author(s): T. Miyazaki
    • Abstract

    Background
    The average age of the general population is increasing in the worldwide. Therefore, there is also an increasing number of elderly patients presenting with potentially-resectable lung cancer. We retrospectively reviewed the outcomes of octogenarians or over who underwent pulmonary resection for primary non-small cell lung cancer (NSCLC) to identify the independent factor of overall survival.

    Methods
    We conducted a retrospective single-institution review of patients aged 80 years or over who underwent pulmonary resection for primary NSCLC from 1990 to 2012 at Nagasaki university hospital. The various clinicopathological data, including gender, histological type, body mass index, comorbidity, clinical stage, surgical procedure, extent of lymph node dissection, and pathological stage were analyzed.

    Results
    119 octogenarians or over underwent pulmonary resection. The median age was 82 years (range 80-92 years). Of the total patient number, 56 (47.1%) had respiratory and 44 (33.6%) had cardiovascular comorbidity diagnosed preoperatively. The clinical stage was I in 97 (81.5%) patients, II in 13, III in 6, IV in 3. Operations included 82 (68.9%) lobectomies, 2 (1.7%) bilobectomies, 15 (12.6%) segmentectomies, and 19 (16.0%) partial resections. Only 31 (26.1%) were performed mediastinal lymph node dissection. The pathological stage was I in 79 (81.5 down to 66.4 %) patients, II in 16 (13.4%), III in 21 (17.7%), IV in 3 (2.5%). 26 (21.8%) patients presented with postoperative respiratory complications, and 11 (9.2%) were cardiovascular, and the operative mortality was 1 (0.8%). The 5-year survival rates were 46.0% for all patients, 60.8% for stage I patients. The disease specific 5-year survival rates were 60.1% for all patients, 79.5% for stage I patients, respectively. In univariate analysis, female (p<0.04), clinical stage (p<0.002), and pathological stage (p<0.000) was independent and cardiovascular comorbidity was marginally (p<0.05) factor for overall survival. In multivariate analysis, only advanced pathologic stage (stage II, more) was independent predictor of overall survival [p<0.0001, Hazard ratio: 3.17, 95% confidence interval 1.76-5.73]. Figure 1

    Conclusion
    Surgical treatment for selected patients aged 80 years or over or with primary NSCLC can be performed safely with low morbidity and mortality in this study. We recommend that limited operation might be the best surgical treatment, especially for stage I NSCLC. In the future, establishment of accurate clinical staging as well as early detection for lung cancer, and the appropriate treatment for advanced stage NSCLC for aged people should be studied for the upcoming aged society.