title: Video-assisted thoracoscopic lobectomy for elderly nonsmall cell lung cancer: Short-term and long-term outcomes.
abstract: BACKGROUND
  Lung cancer is the leading cause of cancer-related death worldwide, and the number of elderly patients with nonsmall-cell lung cancer (NSCLC) has risen with increasing life-expectancy.
  
  
  OBJECTIVE
  To evaluate safety and efficacy of thoracoscopic lobectomy for NSCLC patients above 75 years old.
  
  
  METHODS
  We reviewed the data of 795 consecutive patients with NSCLC, who underwent video-assisted thoracoscopic lobectomy from January 2006 to December 2013. Patients were divided into two groups: The elderly group aged at least 75 years old (n = 54), the contrast group aged <75 years old (n = 741). The general characteristic, comorbidity, intraoperative observations, complications, operative mortality and long-term survival were compared between the two groups.
  
  
  RESULTS
  The elderly group had a higher incidence of squamous cell carcinoma (40.74% vs. 29.69%) and a lower incidence of adenocarcinoma (37.04% vs. 52.63%) than the contrast group (P = 0.083). The ratio of smoking (61.11% vs. 41.97%), preoperative comorbidities (62.96% vs. 38.06%), perioperative blood transfusion (25.93% vs. 13.50%) and thoracic intubation indwelling time (10.3 vs. 8.2 days) in the elderly group were higher (P < 0.01). There was no significant difference in duration of surgery (222.9 vs. 226.6 min), intraoperative blood loss (299.8 vs. 253.5 min), hospital stay (18.2 vs. 15.8 days) or postoperative hospital stay (10.3 vs. 8.4 days) between the two groups. Postoperative morbidities occurred more frequently in the elderly group than the contrast group (24.07% vs. 12.01%, P = 0.018). Thirty-day mortality rate of two groups showed no significant difference (1.85% vs. 0.40%, P = 0.246). The overall survival and recurrence-free survival in the elderly group were comparable with the contrast group (P = 0.114 and 0.092, respectively).
  
  
  CONCLUSIONS
  Video-assisted thoracoscopic lobectomy is a safe and reliable approach with acceptable short- and long-term outcome in the elderly.
authors.forename: Guangliang
authors.initials: G
authors.lastname: Qiang
authors.forename: Chaoyang
authors.initials: C
authors.lastname: Liang
authors.forename: Yongqing
authors.initials: Y
authors.lastname: Guo
authors.forename: Bin
authors.initials: B
authors.lastname: Shi
authors.forename: Yanchu
authors.initials: Y
authors.lastname: Tian
authors.forename: Zhiyi
authors.initials: Z
authors.lastname: Song
authors.affiliation: Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Deruo
authors.initials: D
authors.lastname: Liu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011183:Postoperative Complications; D011379:Prognosis; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy