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

  • 11602

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    P2.07-007 - Surgical treatment of elderly patients with resectable lung cancer (ID 832)

    09:30 - 09:30  |  Author(s): Y. Kawaguchi
    • Abstract

    Background
    The incidence of lung cancer in the older population is increasing. In case of resectable primary lung cancer, surgery remains the best treatment for cure, independent of age. However, the prevalence of co-morbidities among elderly lung cancer patients is significantly higher. A presumed fear of increased postoperative morbidity and mortality in the elderly patients has resulted in the delivery of sub-optimal cancer surgery. We believe all elderly cancer patients should be offered optimal treatment depending on their functional status not on their age; a major step in ensuring this would be to establish the appropriate surgical management protocol for elderly cancer patients. Thus it is important to determine whether the elderly would indeed benefit from the same management standards as their younger counterparts. This study aimed to determine the suitable operative procedures for elderly patients with primary lung cancer.

    Methods
    Between January 2006 and December 2012, 98 patients aged over 75 years with primary lung cancer received lobectomies in our hospital. We divided the patients into group A (75-79 years old) and group B (over80 years old) and analyzed their relapse-free survival and postoperative complication incidence.

    Results
    The patients in group A (46 men and 17 women) had a mean age of 76.8 years, 36 patients had adenocarcinomas, 24 had squamous cell carcinomas, and 3 had other tumors. A mediastinal lymph node dissection (MLND) was performed in 52 patients but not in 11 patients. The patients’ pathological stages were 1A (21), 1B (13), 2A (5), 2B (12), 3A (11), and 4 (1). The 3-year relapse-free survival was 66.3 % (MLND-positive, 62.6 %; MLND-negative, 90.9 %). Postoperative complications occurred in 30.8 % of the MLND-positive patients and 18.2 % of the MLND-negative patients. The patients in group B (26 men and 9 women) had a mean age of 82.4 years, 17 patients had adenocarcinomas, 12 had squamous cell carcinomas, and 6 had other tumors. An MLND was performed in 24 patients but not in 11 patients. The patients’ pathological stages were 1A (12), 1B (10), 2A (5), 2B (3), 3A (1), and 3B (4). The 3-year relapse-free survival was 73.3 % (MLND-positive, 75.7 %; MLND-negative, 68.2 %). Postoperative complications occurred in 16.7 % of the MLND-positive patients and 9.1 % of the MLND-negative patients.

    Conclusion
    This study showed a survival benefit in elderly lung cancer patients who underwent lobectomies. In clinically well-documented early nodal stage disease (N0 patients and N1 patients with limited hilar disease), an MLND did not have a therapeutic effect and thus may not be necessary. Omitting MLNDs in elderly lung cancer patients also provided fewer postoperative complications. In this study, we proved that elderly patients with resectable lung cancer who received lobectomies without MLNDs could achieve long-term survival and be a safe procedure.