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

  • 11610

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    P2.07-015 - Clinical outcome of 16 extremely elder patients (85-year-old or over) with surgically resected non-small cell lung cancer (ID 1364)

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

    Background
    In Japan, an aging society, the number of surgical operations performed in the elderly has been increasing. In this study, to investigate whether the surgical resection of non-small cell lung cancer benefits extremely elder patients (85-year-old or over), we analyzed the clinical outcome of our patients.

    Methods
    Sixteen consecutive patients aged 85 years or older who underwent surgical resection of primary non-small cell lung cancer in our hospital from May 2002 to September 2012 were enrolled in this study. The patients’ operative procedure, respiratory function before operation, histological type, tumor size, clinical stage, comorbidity, surgery-related complications, prognosis, and recurrence were retrospectively reviewed.

    Results
    There were 11 males and 5 females. Their mean age was 86.6 years (range: 85-93 years). The mean follow-up period after operation was 1290 days (range: 249-4029 days). Operative procedures include lobectomy (N=4), segmentectomy (N=6), and wedge resection (N=6). Among them, thoracoscopic surgeries were performed in 14 patients. Patients treated by segmentectomy had poorer pulmonary function than others in terms of the forced expiratory volume in 1 second (FEV1.0) (mean±SD: 1.43±0.40 vs 1.94±0.39 L, p<0.05) and vital capacity (VC) (mean±SD: 2.02±0.51 vs 2.55±0.53 L, p=0.06). Histological type include adenocarcinoma (N=11) and squamous cell carcinoma (N=5). The tumor size ranged 11 mm to 48 mm. All 16 patients were negative for lymph node metastasis. Pathological stage was IA in 11 patients, IB in 4 patients, and IIB in 1 patient. Seven patients had comorbidity (e.g. COPD, post-bypass grafting for coronary aretery, and others). Seven patients were smokers. Mortality rate was 0% and morbidity rate was 25% (e.g. pulmonary fistula treated with pleurodesis in 1 patient, atrial fibrillation in 2 patients, heart failure in 1 patient, and delirium in 1 patient). Fourteen patients are alive, whereas 2 patients died from other diseases than lung cancer. The 2 patients died after 1950 days and 1344 days after operation, respectively. No patients had recurrence during the follow-up period.

    Conclusion
    No patients died from surgery or post-surgical complications. Our study indicates that the surgical resection of non-small cell lung cancer benefits patients, even with extremely elder age (85-year-old or over). For our institution’s principal indications for pulmonary surgery, patients with elder age (75-years-old or older) have to (i) be able to undergo pulmonary physiotherapy, (ii) have good performance status (0-1 in ECOG scale), and (iii) be free from psychological disorder such as dementia. Additionally, in cases with extremely older age (85-year-old or over), we consider patients with clinical stage I or patients without lymph node metastasis are good candidates. Lobectomy can be performed in patients with better pulmonary function, whereas patients with worse pulmonary function should undergo segmentectomy. Wedge resection is selected only if the lesion is judged to be completely resectable. We consider these inclusion criteria and the manner of selecting operative procedures will provide a good prognosis, even though the patient is 85 years or older.