[Is the excision surgery of bronchial cancer in patients over 70 years of age justified?].
The retrospective analysis of 331 files relating to primary bronchial cancer shows that 30% of the patients are 70 years old or over. This patient group is compared to younger subjects who were operated during the same period. For this surgical series, the disease studied is the same whichever the age (detection conditions, excision types, TNM classification). Mortality for excision is comparable (5.1% vs 8.2%), but the type of mortal complications differs according to the age. Our analysis allows isolating two factors of risk (cardiovascular defects and obstructive chronic respiratory failure). Provided that a pre-operation rigorous selection of the patients over 70 years has been made, pneumonectomy does not seem more serious than lobectomy (mortality 3.7% vs 10.3%). For identical stages, remote survival after excision can be compared to that of operated patients under 70 years old. Excision beyond 70 years old seems justified provided that: a selection of patients, from which subjects having major defects (cardiovascular and respiratory) should be excluded, is carried out by appreciating physiological age and not actual age, a pre-operation respiratory preparation is performed, a careful operating technique which allows avoiding surgical complications is used, a peri-operating assistance is provided.
Richelme
H
H
Service de chirurgie abdominale et thoracique, CHU Nice-Pasteur, France.
Bereder
J M
JM
Mouroux
J
J
Bernard
J L
JL
Benchimol
D
D
D000367:Age Factors; D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D011300:Preoperative Care; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
La chirurgie d'exérèse du cancer bronchique après 70 ans est-elle légitime?