title: Risk factor for respiratory death after lung cancer surgery in octogenarians.
abstract: BACKGROUND
  As society ages, the frequency of elderly patients undergoing surgery for lung cancer is increasing. However, the indications for surgery in octogenarians are still controversial. We examined the outcomes of elderly patients undergoing thoracic surgery for lung cancer, focusing especially on non-cancer-related death.
  
  
  METHODS
  Between January 2004 and March 2011, 1673 patients with lung cancer underwent surgical resection at our institution. Of these, we retrospectively examined 174 patients aged 80 years or older.
  
  
  RESULTS
  Perioperative morbidity and mortality were 24.3% and 1.15%, respectively. Of 163 patients who were followed up completely, 78 (47.9%) died. The overall postoperative survival rate at 3 and 5 years was 63.6% and 48.3%, respectively. Almost half of the deaths were due to causes other than lung cancer recurrence, with respiratory disease accounting for the majority. We found that a low body mass index was a significant risk factor for death due to respiratory disease after lung cancer surgery in this patient cohort.
  
  
  CONCLUSIONS
  The overall survival rate of octogenarians undergoing lung cancer surgery is acceptable. However, because octogenarians with a low body mass index have a significantly higher risk of death due to respiratory disease, surgeons and pulmonologists should take this into account when performing postoperative follow-up in these patients.
authors.affiliation: Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji-City, Japan katccha@ares.eonet.ne.jp.
authors.forename: Katsunari
authors.initials: K
authors.lastname: Matsuoka
authors.affiliation: Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji-City, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Ueda
authors.affiliation: Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji-City, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality*; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Aged 80 and over; Body mass index; Lung neoplasms; Pneumonectomy; Pneumonia; Treatment outcome