title: Lung cancer surgery in patients aged 80 years or older: an analysis of risk factors, morbidity, and mortality.
abstract: BACKGROUND
  As the population ages, the age of patients undergoing thoracic surgery increases, and elderly patients often have more comorbidities than younger patients.
  
  
  METHODS
  This retrospective study observed preoperative comorbidities, surgical procedures and postoperative morbidity and mortality after lung cancer surgery in patients 80 years of age or older. The medical records of lung cancer patients 80 years of age or older who underwent surgery from January 2003 to December 2012 were reviewed.
  
  
  RESULTS
  There were 49 patients (27 males, 22 females), with a median age of 83 years. Thirty patients underwent major pulmonary resection and 18 patients underwent limited pulmonary resection. The median Charlson comorbidity index was 3. Although approximately two-thirds of the patients (20 patients; 40.8%) experienced some kind of postoperative morbidity, more than 80% of the complications were grade 1 or 2 according to the Clavien-Dindo classification. Cerebrovascular disease and chronic obstructive pulmonary disease were significantly associated with moderate-to-severe complications. Postoperative death was observed in two cases (4.1%). In addition, an increased American Society of Anesthesiologists classification score and past history of myocardial infarction, congestive heart failure and/or diabetes mellitus with end-organ damage were significantly associated with mortality. The overall survival rate was 79.6% at 3 years and 53.1% at 5 years.
  
  
  CONCLUSIONS
  Thoracic surgery shows acceptable morbidity and mortality in patients 80 years of age or older. Patients 80 years of age or older should be offered the best treatments, including surgery, with careful patient evaluation and selection.
authors: Department of Surgery, Saiseikai Karatsu Hospital, 817, Motohata-machi, Karatsu, Saga, 847-0052, Japan, nooir_nooka@yahoo.co.jp.
authors: Naoko
authors: N
authors: Miura
authors: Mikihiro
authors: M
authors: Kohno
authors: Kensaku
authors: K
authors: Ito
authors: Mayuko
authors: M
authors: Senba
authors: Koutarou
authors: K
authors: Kajiwara
authors: Naohiko
authors: N
authors: Hamaguchi
authors: Hideki
authors: H
authors: Makino
authors: Takanori
authors: T
authors: Kanematsu
authors: Tatsuro
authors: T
authors: Okamoto
authors: Hideki
authors: H
authors: Yokoyama
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000601:surgery; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000401:mortality / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D013510:Pulmonary Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome