Pneumonectomy for Clinical Stage I Non-Small Cell Lung Cancer in Elderly Patients over 70 Years of Age.
BACKGROUND
Lobectomy is the generally accepted standard treatment for early-stage non-small cell lung cancer (NSCLC). However, especially in elderly patients, it is often necessary to perform pneumonectomy in order to maximize the likelihood of curative treatment, although pneumonectomy is a challenging procedure.


METHODS
We analysed patients who were clinically diagnosed with stage I NSCLC and underwent pneumonectomy with curative intent from 2004 to 2011. The patients were divided into an elderly group (≥70 years) and a younger group (<70 years). We retrospectively analysed the outcomes of these groups of patients in order to characterize the role of pneumonectomy as a treatment for elderly patients with clinical stage I NSCLC.


RESULTS
Thirty patients younger than 70 years of age (younger group) and fourteen patients 70 years of age or older (elderly group) who underwent pneumonectomy were enrolled in the present study. The median follow-up period was 35 months (range, 0 to 125 months). The perioperative mortality rate (within 90 days after the operation) was 7.1% in the elderly group and 6.7% in the younger group (p=0.73). No significant differences between the two groups were observed regarding the occurrence of pneumonia, acute respiratory distress syndrome, cardiac arrhythmia, bronchopleural fistula, and vocal cord paralysis. The overall five-year survival rate was 79.4% in the younger group and 35.7% in the elderly group, which was a significant difference (p=0.018). The five-year disease-free survival rate was 66.7% in the younger group and 35.7% in the elderly group, but this difference was not statistically significant (p=0.23).


CONCLUSIONS
Although elderly patients with early stage lung cancer showed a worse long-term survival rate after pneumonectomy than younger patients, the outcomes of elderly patients were similar to those of younger patients in terms of perioperative mortality and postoperative complications. Patients should not be denied pneumonectomy solely due to old age.
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Tae Ho
TH
Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Byungjoon
B
Park
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Jong Ho
JH
Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Hong Kwan
HK
Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Yong Soo
YS
Choi
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine.
Kwhan-Mien
KM
Kim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Young Mog
YM
Shim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Jaeil
J
Zo
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Jhingook
J
Kim
Aged; Geriatrics; Non-small-cell lung carcinoma; Surgery