Advanced age does not exclude lobectomy for non-small cell lung carcinoma.
OBJECTIVE
Localized non-small cell lung carcinoma (NSCLC) is best treated by complete surgical resection, commonly requiring lobectomy. The impact of lobectomy on the health status of the elderly patient is not well-characterized. The aim of this study was to compare the effect of lobectomy in elderly patients (> or = 70 years of age) and younger patients (< 70 years of age) on their pulmonary function and functional status 1 year following surgery.


METHODS
One hundred forty patients underwent lobectomy for NSCLC at the Minneapolis Veterans Affairs Medical Center from January 1999 to December 2003. All patients underwent pulmonary function tests (PFTs) and functional status assessment using Karnofsky scores (KS) that were assessed preoperatively. Sixty-three of 140 lobectomy patients were available 1 year postoperatively for reevaluation by PFTs and KS.


RESULTS
There was no statistical difference between groups in either the pulmonary function or functional status testing results at 1 year after undergoing lobectomy. FVC decreased by 14% in the elderly patient and by 9% in the younger patient group. FEV1 decreased by 19% in elderly patients and by 13% in younger patients. Functional status declined for two older patients (8%), who dropped their KS from 80 to 100% (normal activity without limitation) to 40 to 70% (unable to work, but able to care of self at home). Nine of the younger patients (24%) had KS drop from 80 to 100% to 40 to 70%. There was one perioperative death (30-day mortality rate for the study groups, 1.5%).


CONCLUSIONS
Elderly patients > or = 70 years of age undergoing lobectomy for NSCLC had similar PFT results and functional status as younger patients < 70 years of age 1 year after undergoing surgery. Curative resection should not be denied based on age alone.
Sullivan
Vita
V
Division of Cardiovascular and Thoracic Surgery, University of Minnesota, Minneapolis, USA.
Tran
Tao
T
Holmstrom
Amy
A
Kuskowski
Michael
M
Koh
Paul
P
Rubins
Jeffrey B
JB
Kelly
Rosemary F
RF
D000367:Age Factors; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D012129:Respiratory Function Tests; D013147:Spirometry; D016019:Survival Analysis; D019616:Thoracic Surgical Procedures / Q000401:mortality; D014797:Vital Capacity