Pulmonary resection in patients aged 80 years or over with clinical stage i non-small cell lung cancer

Prognostic factors for overall survival and risk factors for postoperative complications

Jiro Okami, Masahiko Higashiyama, Hisao Asamura, Tomoyuki Goya, Yoshihiko Koshiishi, Yasunori Sohara, Kenji Eguchi, Masaki Mori, Yoichi Nakanishi, Ryosuke Tsuchiya, Etsuo Miyaoka

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

INTRODUCTION: This retrospective study was designed to identify the predictors of long-term survival and the risk factors for complications after surgery in patients aged 80 years or older with clinical (c)-stage I non-small cell lung cancer. METHODS: The Japanese Joint Committee of Lung Cancer Registry collated the clinicopathological profiles and outcomes of 13,344 patients who underwent pulmonary resection for primary lung cancer in 1999. The data of 367 patients aged 80 years or older with c-stage I non-small cell lung cancer were analyzed for prognostic factors and risk factors for postoperative complications. RESULTS: The median age was 82 years (range, 80-90 years). Of the total patient number, 102 (27.8%) had some form of comorbidity diagnosed preoperatively. Thirty-one (8.4%) patients presented with postoperative complications, and the operative mortality was 1.4%. The 5-year survival rates were 55.7% for c-stage I patients, 62.0% for c-stage IA, and 47.2% for c-stage IB. Advanced pathologic stage and comorbidity were significant independent predictors of shortened survival (p < 0.0001 and p = 0.032, respectively). Comorbidity and mediastinal lymph node dissection were identified as factors that increased the risk of postoperative complications (p < 0.0001 and p = 0.036, respectively). Survival rates were independent of the extent of pulmonary resection (lobectomy or limited resection). CONCLUSIONS: Octogenarian patients with c-stage I lung cancer in this study had a satisfactory long-term outcome and low-mortality rate. Comorbidity is a factor associated with both prognosis and operative risks. A selection of the patients who would be curable without mediastinal lymph node dissection after an accurate preoperative staging is beneficial to decrease the postoperative complications because this procedure is a risk factor.

Original languageEnglish
Pages (from-to)1247-1253
Number of pages7
JournalJournal of Thoracic Oncology
Volume4
Issue number10
DOIs
Publication statusPublished - 2009 Oct
Externally publishedYes

Fingerprint

Non-Small Cell Lung Carcinoma
Lung
Survival
Comorbidity
Lung Neoplasms
Lymph Node Excision
Survival Rate
Mortality
Patient Selection
Registries
Retrospective Studies

Keywords

  • Clinical stage I lung cancer
  • Limited resection.
  • Octogenarian
  • Prognostic factor
  • Risk factor for postoperative complication
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Pulmonary resection in patients aged 80 years or over with clinical stage i non-small cell lung cancer : Prognostic factors for overall survival and risk factors for postoperative complications. / Okami, Jiro; Higashiyama, Masahiko; Asamura, Hisao; Goya, Tomoyuki; Koshiishi, Yoshihiko; Sohara, Yasunori; Eguchi, Kenji; Mori, Masaki; Nakanishi, Yoichi; Tsuchiya, Ryosuke; Miyaoka, Etsuo.

In: Journal of Thoracic Oncology, Vol. 4, No. 10, 10.2009, p. 1247-1253.

Research output: Contribution to journalArticle

Okami, Jiro ; Higashiyama, Masahiko ; Asamura, Hisao ; Goya, Tomoyuki ; Koshiishi, Yoshihiko ; Sohara, Yasunori ; Eguchi, Kenji ; Mori, Masaki ; Nakanishi, Yoichi ; Tsuchiya, Ryosuke ; Miyaoka, Etsuo. / Pulmonary resection in patients aged 80 years or over with clinical stage i non-small cell lung cancer : Prognostic factors for overall survival and risk factors for postoperative complications. In: Journal of Thoracic Oncology. 2009 ; Vol. 4, No. 10. pp. 1247-1253.
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T1 - Pulmonary resection in patients aged 80 years or over with clinical stage i non-small cell lung cancer

T2 - Prognostic factors for overall survival and risk factors for postoperative complications

AU - Okami, Jiro

AU - Higashiyama, Masahiko

AU - Asamura, Hisao

AU - Goya, Tomoyuki

AU - Koshiishi, Yoshihiko

AU - Sohara, Yasunori

AU - Eguchi, Kenji

AU - Mori, Masaki

AU - Nakanishi, Yoichi

AU - Tsuchiya, Ryosuke

AU - Miyaoka, Etsuo

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N2 - INTRODUCTION: This retrospective study was designed to identify the predictors of long-term survival and the risk factors for complications after surgery in patients aged 80 years or older with clinical (c)-stage I non-small cell lung cancer. METHODS: The Japanese Joint Committee of Lung Cancer Registry collated the clinicopathological profiles and outcomes of 13,344 patients who underwent pulmonary resection for primary lung cancer in 1999. The data of 367 patients aged 80 years or older with c-stage I non-small cell lung cancer were analyzed for prognostic factors and risk factors for postoperative complications. RESULTS: The median age was 82 years (range, 80-90 years). Of the total patient number, 102 (27.8%) had some form of comorbidity diagnosed preoperatively. Thirty-one (8.4%) patients presented with postoperative complications, and the operative mortality was 1.4%. The 5-year survival rates were 55.7% for c-stage I patients, 62.0% for c-stage IA, and 47.2% for c-stage IB. Advanced pathologic stage and comorbidity were significant independent predictors of shortened survival (p < 0.0001 and p = 0.032, respectively). Comorbidity and mediastinal lymph node dissection were identified as factors that increased the risk of postoperative complications (p < 0.0001 and p = 0.036, respectively). Survival rates were independent of the extent of pulmonary resection (lobectomy or limited resection). CONCLUSIONS: Octogenarian patients with c-stage I lung cancer in this study had a satisfactory long-term outcome and low-mortality rate. Comorbidity is a factor associated with both prognosis and operative risks. A selection of the patients who would be curable without mediastinal lymph node dissection after an accurate preoperative staging is beneficial to decrease the postoperative complications because this procedure is a risk factor.

AB - INTRODUCTION: This retrospective study was designed to identify the predictors of long-term survival and the risk factors for complications after surgery in patients aged 80 years or older with clinical (c)-stage I non-small cell lung cancer. METHODS: The Japanese Joint Committee of Lung Cancer Registry collated the clinicopathological profiles and outcomes of 13,344 patients who underwent pulmonary resection for primary lung cancer in 1999. The data of 367 patients aged 80 years or older with c-stage I non-small cell lung cancer were analyzed for prognostic factors and risk factors for postoperative complications. RESULTS: The median age was 82 years (range, 80-90 years). Of the total patient number, 102 (27.8%) had some form of comorbidity diagnosed preoperatively. Thirty-one (8.4%) patients presented with postoperative complications, and the operative mortality was 1.4%. The 5-year survival rates were 55.7% for c-stage I patients, 62.0% for c-stage IA, and 47.2% for c-stage IB. Advanced pathologic stage and comorbidity were significant independent predictors of shortened survival (p < 0.0001 and p = 0.032, respectively). Comorbidity and mediastinal lymph node dissection were identified as factors that increased the risk of postoperative complications (p < 0.0001 and p = 0.036, respectively). Survival rates were independent of the extent of pulmonary resection (lobectomy or limited resection). CONCLUSIONS: Octogenarian patients with c-stage I lung cancer in this study had a satisfactory long-term outcome and low-mortality rate. Comorbidity is a factor associated with both prognosis and operative risks. A selection of the patients who would be curable without mediastinal lymph node dissection after an accurate preoperative staging is beneficial to decrease the postoperative complications because this procedure is a risk factor.

KW - Clinical stage I lung cancer

KW - Limited resection.

KW - Octogenarian

KW - Prognostic factor

KW - Risk factor for postoperative complication

KW - Surgery

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