Outcomes in Octogenarians Undergoing High-Risk Cancer Operation: A National Study

Finlayson, Emily; Fan, Zhaohui; Birkmeyer, John D.

doi:10.1016/j.jamcollsurg.2007.06.307

Cited by 297 publications

(240 citation statements)

References 8 publications

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“…A recent study found that hypertension, diabetes mellitus, and smoking history were the strongest predictors of cardiovascular disease in breast cancer survivors X65 years old (Haque et al, 2014). Not surprisingly, several studies have observed that cancer patients with a comorbidity had worse 5-year survival compared with those without comorbidity, with hazard ratios ranging from 1.1 to 5.8 (Finlayson et al, 2007;Sogaard et al, 2013). Furthermore, older age was associated with septic complications in the present study, and there is increasing evidence that sepsis is not only associated with an increased risk of cancer-related mortality but also cardiovascular events (Yende et al, 2014;Ou et al, 2016;Park et al, 2016).…”

Section: Discussionsupporting

confidence: 57%

The impact of age on complications, survival, and cause of death following colon cancer surgery.

Aquina

Mohile

Tejani

et al. 2016

JCO

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Section: Discussionsupporting

confidence: 57%

The impact of age on complications, survival, and cause of death following colon cancer surgery.

Aquina

Mohile

Tejani

et al. 2016

JCO

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“…Elderly patients, particularly those with multiple comorbidities and an impaired performance status, are at high operative risk and do not have the same survival benefits observed in younger patients. 2,3,20 Several factors that predict for prolonged length of hospital stay (PLOS) have been identified, 36 and our cohort of mainly elderly men who were smokers with COPD and had high average comorbidity scores, by definition, have a high PLOS score. Hospitalization is the single largest component of net costs for elderly patients with cancer during any phase of care, and it is estimated that more than half the cost of initial lung cancer care consists of hospitalization costs.…”

Section: Discussionmentioning

confidence: 99%

“…16 Counseling of elderly patients should include information about the likelihood of convalescence at an extended care facility, because approximately 24% of octogenarians are transferred to extended care facilities after undergoing pulmonary resection, and physicians should be aware of the added costs. 2 Steps to standardize the delivery of SRT are essential to ensure the safe use of this technique. 34 Although the capital expenditure in stereotactic radiation equipment and well trained, specialized staff is considerable, the costeffectiveness of the short outpatient procedure in the setting of an aging population is self evident.…”

Section: Discussionmentioning

confidence: 99%

Stage I nonsmall cell lung cancer in patients aged ≥75 years

Haasbeek

Lagerwaard

Antonisse

et al. 2009

Cancer

165

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BACKGROUND:The number of patients aged !75 years who present with a stage I nonsmall cell lung cancer (NSCLC) is increasing. Elderly patients often have significant comorbidity and may be unfit for surgery. Furthermore, surgery in the elderly is associated with increased mortality and morbidity. In this study, the authors evaluated the outcomes of stereotactic radiotherapy (SRT) in elderly patients. METHODS: Since 2003, 203 tumors in 193 patients aged !75 years were treated using SRT (118 T1 tumors, 85 T2 tumors). The median patient age was 79 years, 80% of patients were considered medically inoperable, and 20% of patients declined surgery. The median Charlson comorbidity score was 4, and severe chronic obstructive pulmonary disease (Global Initiative for Chronic Obstructive Lung Disease Class III or greater) was present in 25% of patients. Risk-adapted SRT schemes were used with the same total dose of 60 grays in 3 fractions (33%), 5 fractions (50%), or 8 fractions (17% of patients), depending on the patient's risk for toxicity. RESULTS: SRT was well tolerated, and all but 1 patient completed treatment. Survival rates at 1 year and 3 years were 86% and 45%, respectively. Survival was correlated with performance score (P ¼ .001) and pre-SRT lung function (P ¼ .04). The actuarial local control rate at 3 years was 89%. Acute toxicity was uncommon, and late Radiation Therapy Oncology Group grade !3 toxicity was observed in <10% of patients. CONCLUSIONS: SRT achieved high local control rates with minimal toxicity in patients aged !75 years despite their significant medical comorbidities. These results indicated that more active diagnostic and therapeutic approaches are justified in elderly patients and that SRT should be considered and discussed as a curative treatment alternative. Cancer 2010;116:406-14.

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“…9) But current reports and guidelines suggested that high age was not regarded as a contraindication for curative operation. 10 postoperative morbidities.…”

Section: Discussionmentioning

confidence: 99%

Results of Lung Cancer Surgery for Octogenarians

Hino

Murakawa

Ichinose

et al. 2015

ATCS

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Purpose: Growing number of elderly lung cancer patients reflecting a lengthening life span has become a serious problem. Purpose of this study was to elucidate the short and long-term outcome of the surgery for octogenarians, and to evaluate the role of lung cancer surgery for this high age group. Methods: The patients with lung cancer aged 80 years or more who underwent the surgery at our institute from January 1998 through December 2012 were retrospectively analyzed by chart review, and the operative mortality, morbidity and the long-term survival were assessed. Results: Out of a total of 1107 patients with primary lung cancer who received surgery during the study period, 94 were octogenarians (8.5%). Sixty-nine patients (73.4%) had preoperative co-morbidity including hypertension in 50 (53.2%), coincidence of other malignancy in 35 (37.2%), anti-coagulant therapy in 29 (30.9%). Twenty-six patients (27.7%) had major or minor postoperative morbidity, and one (1.1%) died due to bronchopleural fistula. Overall-5-year survival rate was 57.5%. Univariative and multivariative analysis using Cox proportional hazard model revealed that male gender and non-adenocarcinoma histology were significant risk factors for poor prognosis. Conclusion: Gender and histology should be taken into account in preoperative evaluation of indication for lung cancer in octogenarians.

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Outcomes in Octogenarians Undergoing High-Risk Cancer Operation: A National Study

Cited by 297 publications

References 8 publications

The impact of age on complications, survival, and cause of death following colon cancer surgery.

The impact of age on complications, survival, and cause of death following colon cancer surgery.

Stage I nonsmall cell lung cancer in patients aged ≥75 years

Results of Lung Cancer Surgery for Octogenarians

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