Author of

• 15301

  +

  P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Localized Disease - NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15331

    +

    P3.02-030 - Linguar-Sparing Left Upper Lobectomy for Lung Cancer in a 97 Year Old Man (ID 488)

    09:30 - 09:30  |  Author(s): H. Wilson
    • Abstract

    Background:
    Current trends in increased life-expectancy and lung cancer incidence have led to a growing number of elderly patients with non-small cell lung cancer. Advances in surgical techniques and perioperative care have led to improved outcomes in octogenarians undergoing pulmonary resection. There have been few reports, however, of surgical management in patients over the age of ninety years. Between 2009 and 2011 a total of 5133 new cases of lung cancer were reported in people over the age of 85 years in the UK. In view of this, clinicians will face more difficult decisions as to the management of lung cancer in elderly patients. Here we report the case of a 97 year old man with NSCLC successfully treated with anatomical pulmonary resection. To the best of our knowledge this is the oldest individual reported to have undergone this lung cancer surgery.
    
    Methods:
    A 97 year old gentleman presented with a cough and was found to have an abnormal chest x-ray. CT scan demonstrated a lesion within the apex of the left upper lobe, which was confirmed as a squamous cell carcinoma on CT guided biopsy. Further staging was carried out with a PET scan showing a T2b N0 M0 disease. At review the patient appeared to be a fit and active gentleman with a good exercise tolerance of a half mile without any shortness of breath and at least one flight of stairs. He had a past history of stroke four years ago with no significant residual neurology. He also had a history of hypertension, diabetes, raised cholesterol and chronic renal impairment. Pulmonary function tests were reasonable with an FEV1 of 1.75L (75% predicted) and an FVC of 2.5L (96% predicted).
    
    Results:
    Following counselling regarding management options and risk the patient opted for surgical resection. A left lingular-sparing upper lobectomy was performed via posterolateral thoracotomy. Lymph nodes were taken from stations 5, 7 and 10. Postoperative airleak was prolonged with drain removal on day 10. In addition, the patient developed a pseudomonas urinary tract infection which required a course of antibiotics. The postoperative course was otherwise unremarkable and he was discharged home on day 14. At follow-up in the outpatient clinic 6 weeks following surgery the patient had returned to his pre-operative exercise tolerance.
    
    Conclusion:
    Lung cancer is the leading cause of cancer death in both men and women in the UK. In the past there has been a trend towards a less aggressive approach in elderly patients. Here we present successful anatomical pulmonary resection for NSCLC in a 97 year old. A significant number of studies have demonstrated the feasibility of anatomic lung resection in carefully selected octogenarians with acceptable morbidity and mortality. Although there are only a few case reports of surgical management in patients over ninety years old it is fair to assume that similar criteria could be used for patient selection. Surgical resection remains the gold-standard of care for curative intent in early lung cancers and should not be precluded based on age alone.