Comparison of Surgical Outcomes and Survival between Octogenarians and Younger Patients after Pulmonary Resection for Stage I Lung Cancer
Autor: | Jae Kil Park, Young Kyu Moon, Seokbeom Hong |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Survival lcsh:Surgery 030204 cardiovascular system & hematology Stage ib 03 medical and health sciences 0302 clinical medicine Non-small cell lung cancer Clinical Research Medicine Stage (cooking) Mortality Lung cancer Aged 80 and over Stage I Lung Cancer business.industry Medical record Hazard ratio lcsh:RD1-811 medicine.disease Surgery Pneumonia 030228 respiratory system Pulmonary resection Cardiology and Cardiovascular Medicine business |
Zdroj: | Korean Journal of Thoracic and Cardiovascular Surgery, Vol 51, Iss 5, Pp 312-321 (2018) The Korean Journal of Thoracic and Cardiovascular Surgery |
Popis: | Background: Treatment strategies for octogenarians with lung cancer remain controversial. The purpose of this study was to compare surgical outcomes and survival between octogenarians and younger patients with stage IA and IB lung cancer. Methods: We reviewed the medical records of 34 consecutive octogenarians and 457 younger patients (<70 years) with stage I lung cancer who underwent surgical resection from January 2007 to December 2015. We analyzed the survival and surgical outcomes of the 2 groups according to the lung cancer stage (IA and IB). Results: The only significant differences in the clinicopathological features between the groups were the higher proportion of sublobar resection (56.3% vs. 18.9%) and the smaller number of dissected lymph nodes (LNs) in octogenarians. There was no significant difference in hospital stay (11 days vs. 9 days), pneumonia (5.8% vs 1.9%), or operative mortality (0% vs 0.6%) between the 2 groups. Among patients with stage IA lung cancer, 5-year recurrence-free survival was not significantly different between the octogenarians (n=16) and younger patients (n=318) (86.2% vs. 89.1%, p=0.548). However, 5-year overall survival was significantly lower in octogenarians than in younger patients (79.4% vs. 93.4%, p=0.009). Among patients with stage IB lung cancer, there was no significant difference in 5-year recurrence-free survival (62.1% vs. 73.5%, p=0.55) or overall survival (77.0% vs 85.0%, p=0.75) between octogenarians (n=18) and younger patients (n=139). In multivariable analysis, male sex, the number of dissected LNs, and tumor size were factors related to survival (hazard ratio [HR], 5.795; p=0.017; HR, 0.346, p=0.025; and HR, 1.699; p=0.035, respectively). Conclusion: Surgical outcomes and survival after pulmonary resection for stage I lung cancer were comparable in octogenarians and younger patients. Continued careful selection of octogenarians for pulmonary resection is important to achieve good results. |
Databáze: | OpenAIRE |
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