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O. Kawashima

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    P1.07 - Poster Session 1 - Surgery (ID 184)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Surgery
    • Presentations: 1
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      P1.07-018 - Surgical Treatment for Super-elderly Patients ( over 85 years old ) with Lung Cancer (ID 1414)

      09:30 - 16:30  |  Author(s): O. Kawashima

      • Abstract

      It is by now widespread that surgical resection is standard curative treatment for lung cancer, however in super-elderly cancer patients (over 85 years old) there is no clear evidence of safety and efficacy of surgical approach. This study attempts to clarify the benefit of surgical treatment for them.

      Between January 2002 and December 2012, among 1229 consecutively treated patients with primary lung cancer who underwent surgical resection, 29 patients (2.4%) were over 85 years old. Clinicopathological information on these patients was retrospectively reviewed and the surgical outcome was investigated.

      There were 21 men and 8 women, with a mean age of 86.5 years old (range, 85-91 years old). All patients were selected as operable candidates based on the results of routine staging procedures consisting of physical examination, blood chemistry, chest roentgenograms, bronchoscopy, computed tomography of the thorax, abdomen, MRI of brain, and radionuclide bone scanning. Indications for surgery included clinical stage I,II, or IIIA (except bulky N2 ) disease. The surgical procedure was lobectomy in 19 patients, sleeve lobectomy in 2 patients, segmentectomy in 1 patient, and wedge resection in 7 patients. Curative operation ratio was 75.9%. The median intraoperative blood loss and operative time were 96 ml and 165 min. There was no blood transfusion case in this series. Postoperative pathological stage was stage IA in 11 patients, IB in 8 patients, IIA in 1 patient, IIB in 5 patients, IIIA in 2 patients, IIIB in 1 patient. 25 patients (86%) were what is called limited disease. Histological diagnosis was adenocarcinoma in 14 (48.3%) patients, squamous cell carcinoma in 11(37.9%) patients, large cell neuroendocrine carcinoma (LCNEC) in 2 (6.9%) patients, large cell carcinoma in 1 (3.45%) patient, undifferentiated carcinoma in 1 (3.45%) patient. Patients presented postoperative complications in high rate. The complications recorded were delirium in 9 (31.0%) patients, respiratory failure 3 (10.3%) patients, acute renal failure in 2 (6.9%) patients, angina attack in 2 (6.9%) patients, atrial fibrillation in 1(3.5%) patient, cerebral infarction in 1 (3.5%) patient. Although surgical morbidity rate was 62.1%, surgical mortality rate was 0%. 14 patients died until now, 7 of them were recurrent death. Overall patient 1, 3, and 5 years survival rate were 100%, 68.5% and 38.6%, respectively. Postoperative hospital days were 19.5±7.51. 

      Although surgical morbidity rate is high and postoperative hospital days is long, surgical results in this study are acceptable and support the value of surgical treatment in super-elderly patients with lung cancer.