Lung cancer surgery in the elderly

Prediction of Surgical Outcome by Modeling Based on Risk Factors of Morbidity After Pulmonary Resection for Lung Cancer in Older Adults

“…For instance, unexpected intraoperative conditions may result in a longer operation time or more blood loss. Respiratory physiotherapy or proper analgesia in the early postoperative period probably also has an impact on morbidity [5,13]. Moreover, some other predictors in previous models, such as histologic features of the tumor or pathologic staging that could be confirmed only postoperatively, were also beyond the scope of this study [8,12].…”

“…Although another model validated and refined by Kates and colleagues [12] predicted postoperative mortality rates in older patients, it unfortunately, had poor applicability for clinical practice and could not predict morbidity. In fact, postoperative morbidity rates in older patients, ranging from 15% to 67%, are higher and more noteworthy than mortality rates, which are reported to be approximately 2% to 12% [5,[12][13][14]. Thus, morbidity probably reveals more information as the dependent variable in a prediction model instead of mortality.…”

“…At present, more than 20% of all patients undergoing surgical treatment of lung cancer are more than 70 years old [4,5]. In the near future, this number can be expected to exceed 40% [5]. However, when treating older patients, surgeons must carefully balance the risks of morbidity and mortality with the benefit of long-term survival.…”

“…Surgical treatment for early-stage lung cancer has proven to provide an equivalent survival benefit in older patients compared with their younger counterparts [2][3][4]. At present, more than 20% of all patients undergoing surgical treatment of lung cancer are more than 70 years old [4,5]. In the near future, this number can be expected to exceed 40% [5].…”

Lung Cancer in Elderly

“…Many of these changes may affect the tolerance to cancer treatment as; decreased renal and liver functions, decreased volume of distribution, immune response and intestinal absorption (Avery et al, 2009). Talking more specifically about lung function, age-related pulmonary changes include a decreased response to hypoxemia or hypercapnia, decreased elasticity of the lung tissue, increased ventilation-perfusion mismatch, and decreased forced expiratory volume (Gonzalez-Aragoneses et al, 2009). …”