The influence of comorbidity on the postoperative survival in elderly (≥ 75 years old) with lung cancer
| Autor: | Takeshi Fukami, Mototsugu Shimokawa, Mitsuhiro Takenoyama, Yoshinori Yamashita, Tsuyoshi Ueno, Eiji Yatsuyanagi, Osamu Kawashima, Seiichi Fukuyama, Tokujiro Yano |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Lung Neoplasms Comorbidity 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Postoperative Complications Japan Surgical oncology Internal medicine Carcinoma Non-Small-Cell Lung Clinical endpoint Medicine Humans Postoperative Period Prospective Studies Stage (cooking) Lung cancer Pneumonectomy Aged Aged 80 and over business.industry General Medicine medicine.disease Prognosis Confidence interval Cardiac surgery Survival Rate Cardiothoracic surgery 030220 oncology & carcinogenesis Surgery Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | General thoracic and cardiovascular surgery. 66(6) |
| ISSN: | 1863-6713 |
| Popis: | We conducted a multi-institutional prospective observational study of elderly patients (≥ 75 years-old) with resected non-small cell lung cancer. In this report, we have followed the cohorts for 2 years after surgery and examined both the influence of preoperative comorbidity [Adult Comorbidity Evaluation-27 (ACE-27) index] on the postoperative survival and the change in the Karnofsky Performance Status (KPS). From March 2014 to April 2015, 264 patients were prospectively registered from 22 hospitals affiliated with the National Hospital Organization. The mean age at the time of surgery was 79.3 years (range 75–90 years), and 41% of the patients were ≥ 80 years of age. A total of 26% underwent sublobar resection. The study endpoints were the postoperative overall survival (OS), its prognostic factors, and the changes in the postoperative KPS. The 2-year OS was 85.3% (95% confidence interval 80.4–89.1%). Male gender, age ≥ 80, a smoking history, grade 2 of ACE-27, and an advanced disease stage were significantly poor prognostic factors for the OS in the univariate risk analysis. The multivariate analysis showed that male gender, age ≥ 80, an advanced disease stage and sublobar resection were significantly poor prognostic factors for the OS. In comparison with the preoperative KPS, no marked decline was observed in the postoperative chorological change of KPS. In the surgical treatment of elderly patients, the comorbidity as assessed by the ACE-27 index might affect the postoperative survival, and therefore should be taken into accounts in the preoperative evaluation of the surgical indications. |
| Databáze: | OpenAIRE |
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