Impact of mediastinal lymph node dissection on octogenarians with non-small cell lung cancer.
OBJECTIVE
Impacts of mediastinal lymph node dissection on a patient's course after pulmonary resection is unclear in octogenarians with non-small cell lung cancer.


METHODS
Retrospectively identified subjects included 39 octogenarians and 1 nonagenarian, with grades according to the Charlson Comorbidity Index ranging from only 0 to 2. We performed mediastinal lymph node dissection in 19 patients (D group), and just lymph node sampling biopsy in the other 21 (S group). We compared clinicopathologic features and outcome after surgery between both groups.


RESULTS
Deterioration of performance status at the time of discharge, evident in 17 patients overall, was significantly more frequent in the D group. Postoperative complications occurred in 27 patients overall and there was no significant difference between the two groups. Survival rates in younger patients at 1, 3, and 5 years were 86, 59, and 49%, respectively; in octogenarians these were 83, 58, and 42% (no significant difference). Nor did survival differ significantly by surgical management of mediastinal lymph nodes; 1-, 3-, and 5-year survival rates were 94, 63, and 40%, respectively in the D group and 78, 66, and 43%, respectively in the S group.


CONCLUSIONS
Octogenarians with non-small cell lung cancer should be treated by urgent pulmonary resection whenever possible. Since mediastinal lymph node dissection has little effect on long-term survival or the carried risk of worsening performance status at discharge, pulmonary resection without complete mediastinal lymph node dissection should be considered.
Mizuguchi
Shinjiro
S
Department of Thoracic Surgery, Osaka City University Hospital, Japan.
Inoue
Kiyotoshi
K
Iwata
Takashi
T
Izumi
Nobuhiro
N
Tsukioka
Takuma
T
Morita
Ryuhei
R
Nishida
Tatsuya
T
Nishiyama
Noritoshi
N
Shuto
Taichi
T
Suehiro
Shigefumi
S
D000367:Age Factors; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D015996:Survival Rate