title: Lobectomy by video-assisted thoracic surgery for lung cancer patients aged 80 years or more.
abstract: To clarify the usefulness of video-assisted lobectomy for lung cancer patient aged 80 years old or more, a retrospective study was conducted to evaluate the clinical outcome. Between 1982 and 2001, 914 patients underwent surgery for primary lung cancer at the Nippon Medical School Hospital. Among them, 32 patients underwent lobectomy, including 17 with a mean age of 82 years (range, 80 to 91 years) who underwent video-assisted lobectomy and 15 with a mean age of 82 years (range, 80 to 86 years) who underwent lobectomy by standard thoracotomy. Of these 32 patients, clinical outcome was evaluated retrospectively. Mortality was 4 (12.5%) of 32 patients consisting of 3 (20%) of 15 who underwent lobectomy by standard thoracotomy and 1 (5.9%) of 17 who underwent video-assisted lobectomy. Single variate analyses revealed that the presence of preoperative cardiopulmonary disease, 0.6 L or more of predicted postoperative forced expiratory volume in one second/m(2), 700 ml or more of blood loss, five hours or more of duration of operation and two or more of postoperative complications were considered as risk factors regarding mortality within three months postoperation. Among the patients who underwent lobectomy with mediastinal lymph node dissection, the 5-year survival rate at stage I (IA+IB) was 55.6% for patients who underwent video-assisted lobectomy and 0% for patients who underwent lobectomy by standard thoracotomy (IA=2, IB=2). Video-assisted lobectomy for lung cancer patients aged 80 years or more is considered to offer an acceptable clinical outcome. However, further observation on prognosis is necessary.
authors.affiliation: Department of Surgery II, Nippon Medical School, Tokyo, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Shuji
authors.initials: S
authors.lastname: Haraguchi
authors.forename: Tomomi
authors.initials: T
authors.lastname: Hirata
authors.forename: Kyoji
authors.initials: K
authors.lastname: Hirai
authors.forename: Iwao
authors.initials: I
authors.lastname: Mikami
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fukushima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Okada
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamagishi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nakayama
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Akiyama
authors.forename: Shigeo
authors.initials: S
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome