Pneumonectomy for clinical stage I non-small cell lung cancer in elderly patients over 70 years of age

Tae Ho Kim, Byungjoon Park, Jong Ho Cho, Hong Kwan Kim, Yong Soo Choi, Kwhan Mien Kim, Young Mog Shim, Jaeil Zo, Jhingook Kim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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). Conclusion: 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.

Original languageEnglish
Pages (from-to)252-257
Number of pages6
JournalKorean Journal of Thoracic and Cardiovascular Surgery
Volume48
Issue number4
DOIs
StatePublished - 1 Jan 2015

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Pneumonectomy
Non-Small Cell Lung Carcinoma
Survival Rate
Vocal Cord Paralysis
Mortality
Adult Respiratory Distress Syndrome
Disease-Free Survival
Fistula
Cardiac Arrhythmias
Lung Neoplasms
Pneumonia
Therapeutics
Age Groups

Keywords

  • Aged
  • Geriatrics
  • Non-small-cell lung carcinoma
  • Surgery

Cite this

Kim, Tae Ho ; Park, Byungjoon ; Cho, Jong Ho ; Kim, Hong Kwan ; Choi, Yong Soo ; Kim, Kwhan Mien ; Shim, Young Mog ; Zo, Jaeil ; Kim, Jhingook. / Pneumonectomy for clinical stage I non-small cell lung cancer in elderly patients over 70 years of age. In: Korean Journal of Thoracic and Cardiovascular Surgery. 2015 ; Vol. 48, No. 4. pp. 252-257.
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title = "Pneumonectomy for clinical stage I non-small cell lung cancer in elderly patients over 70 years of age",
abstract = "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). Conclusion: 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.",
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Pneumonectomy for clinical stage I non-small cell lung cancer in elderly patients over 70 years of age. / Kim, Tae Ho; Park, Byungjoon; Cho, Jong Ho; Kim, Hong Kwan; Choi, Yong Soo; Kim, Kwhan Mien; Shim, Young Mog; Zo, Jaeil; Kim, Jhingook.

In: Korean Journal of Thoracic and Cardiovascular Surgery, Vol. 48, No. 4, 01.01.2015, p. 252-257.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pneumonectomy for clinical stage I non-small cell lung cancer in elderly patients over 70 years of age

AU - Kim, Tae Ho

AU - Park, Byungjoon

AU - Cho, Jong Ho

AU - Kim, Hong Kwan

AU - Choi, Yong Soo

AU - Kim, Kwhan Mien

AU - Shim, Young Mog

AU - Zo, Jaeil

AU - Kim, Jhingook

PY - 2015/1/1

Y1 - 2015/1/1

N2 - 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). Conclusion: 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.

AB - 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). Conclusion: 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.

KW - Aged

KW - Geriatrics

KW - Non-small-cell lung carcinoma

KW - Surgery

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