Lung cancer in patients aged 80 years and over

Satoh, Hiroaki; Kurishima, Koichi; Nakamura, Ryota; Ishikawa, Hiroichi; Kagohashi, Katsunori; Ohara, Gen; Ishikawa, Shigemi; Ohtsuka, Morio; Sekizawa, Kiyohisa; Hizawa, Nobuyuki

doi:10.1016/j.lungcan.2008.10.020

Cited by 24 publications

(12 citation statements)

References 32 publications

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“…Number of patients with metastasis confined to organ A only/number of patients with metastasis to organ A. b Number of patients with metastasis confined to organs A and B only/number of patients with metastasis to organs A and B. CI, confidence interval. (17,18). The most common sites of metastasis encountered in pretreatment evaluations are the lung, bone, brain, liver and adrenal gland (19)(20)(21)(22).…”

Section: P(a) (95% Ci) ----------------------------------------------mentioning

confidence: 99%

Application of conditional probability analysis to distant metastases from lung cancer

et al. 2011

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Abstract. The aim of this study was to reveal whether there was non-randomness in the occurrence of metastasis and, if the nonrandomness was denied, whether there were specific metastatic patterns in lung cancer patients. Patients who presented with pathologically diagnosed lung cancer between January 1986 and March 2009 at our hospitals were included. A statistical method and conditional probability analysis were used to analyze the data. Under the condition of one metastatic organ A (lung, bone, brain, liver or adrenal gland; the 5 most common metastatic organs), we determined the conditional probability of distant metastasis to a specific organ B, which was written as P(B⎪A), and compared it with the probability of distant metastasis P(B). The study group consisted of 1,994 patients. Of the 1,994 patients, 839 (42.1%) had distant metastases at the time of the initial diagnosis of lung cancer. With the exception of the comparisons between P(lung) and P(lung⎪adrenal gland) and between P(adrenal gland) and P(adrenal gland⎪lung), there were statistically significant differences between P(B⎪A) and P(B) in the 5 metastatic organs. In addition, P(B⎪A) and P(C⎪B⎪A) varied according to each organ and P(confined to A), P(confined to A and B) and P(confined to A, B and C) were different in each metastatic organ. In lung cancer patients, distant metastasis occurred non-randomly and there may be certain specific patterns of distant metastasis. The accumulation of knowledge of specific patterns of metastasis may aid the approach to individualized treatments.

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Section: P(a) (95% Ci) ----------------------------------------------mentioning

confidence: 99%

Application of conditional probability analysis to distant metastases from lung cancer

et al. 2011

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“…Thoracic surgeons increasingly consider lung resection for octogenarians, as the percentage of patients that are found to have lung cancer who are 80 years or older is 7.5 to 17% and increasing with time [2-6]. Likely because of the increased risks associated with age, patients with non-small-cell lung cancer over 80 years of age are less likely to undergo potentially curative surgery [2-7].…”

Section: Introductionmentioning

confidence: 99%

A model for morbidity after lung resection in octogenarians

Berry

Onaitis

Tong

et al. 2011

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES Age is an important risk factor for morbidity after lung resection. This study was performed to identify specific risk factors for complications after lung resection in octogenarians. METHODS A prospective database containing patients aged 80 years or older who underwent lung resection at a single institution between January 2000 and June 2009 was reviewed. Preoperative, histopathologic, perioperative, and outcome variables were assessed. Morbidity was measured as a patient having any perioperative event as defined by the Society of Thoracic Surgeons General Thoracic Surgery Database. A multivariable risk model for morbidity was developed using a panel of established preoperative and operative variables. Survival was calculated using the Kaplan-Meier method. RESULTS During the study period, 193 patients aged 80 years or older (median age 82) underwent lung resection: wedge resection in 77, segmentectomy in 13, lobectomy in 96, bilobectomy in 4, and pneumonectomy in 3. Resection was accomplished via thoracoscopy in 149 patients (77%). Operative mortality was 3.6% (7 patients) and morbidity was 46% (89 patients). Patient discharge disposition was directly to home in 181 patients (94%). Postoperative events included atrial arrhythmia in 38 patients (20%), prolonged air leak in 24 patients (12%), postoperative transfusion in 22 patients (11%), delirium in 16 patients (8%), need for bronchoscopy in 14 patients (7%), and pneumonia in 10 patients (5%). Significant predictors of morbidity by multivariable analysis included resection greater than wedge (odds ratio 2.98, p=0.0064), thoracotomy as operative approach (odds ratio 2.64, p=0.034), and % predicted Forced Expiratory Volume in 1 second (odds ratio 1.28 for each 10% decrement, p=0.01). CONCLUSIONS Octogenarians can undergo lung resection with low mortality. Extent of resection, use of a thoracotomy, and impaired lung function increase the risk of complications. Careful evaluation is necessary to select the most appropriate approach in octogenarians being considered for lung resection.

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“…We previously reviewed the clinical data of the consecutive elderly lung cancer patients diagnosed between 1978 and 2007 at our hospitals [28]. In the study, the 80 age group had higher prevalence of comorbid disease than the 80 < age groups.…”

Section: Discussionmentioning

confidence: 99%