Surgical Treatment for Lung Cancer in Octogenarians

Abstract

We thus conclude that a limited operation without lymph node dissection might be the best surgical treatment for carefully selected octogenarians with clinical stage I NSCLC.

Surgical strategy for non‐small cell lung cancer in octogenarians

“…Pneumonectomy appeared to be associated with increased morbidity and mortality. There have been few retrospective studies in this field, 4–8,14,10,15 and no evidence‐based consensus has been established regarding the use of surgical treatment people aged 80 years and above. Romano and Mark analysed the results of 12 439 patients operated on for lung cancer.…”

“…Avoiding systematic lymph node dissection may decrease morbidity, and Aoki reported that lobectomy without radical systematic lymph node dissection was a satisfactory operation for clinical stage I lung cancer in the elderly 6 . Muraoka advocated limited resection without lymph node dissection for carefully selected elderly stage I patients 7 . While further study is necessary to clarify the influence of lymph node dissection on the postoperative outcome, a lower complication rate would be expected in patients without lymph node dissection.…”

“…Although there is an increased risk of local recurrence after limited resection compared with lobectomy, 2 it is one option available to reduce peri‐operative mortality and morbidity, especially for the very elderly. As people aged 80 years and over have a shorter life expectancy and are also at risk for life‐threatening diseases apart from lung cancer, the therapeutic strategy may need to be different from that of younger lung cancer patients 4–8 . Carefulselection of patients and operative procedures are key issues for the optimal choice of surgical treatment for very elderly.…”

Are we treating enough elderly patients with early stage non-small cell lung cancer?

“…However, several studies support that surgical treatment of NSCLC in the elderly is feasible and that age itself is not a contraindication for surgical intervention [25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43], even in octogenarians [44][45][46][47][48][49][50][51]. Moreover, studies comparing outcomes between younger and older age groups have not demonstrated a significant difference in overall survival [21,34,[36][37][38]45], or in the patient's post-operative functional status [39].…”

Pulmonary Resection for Lung Cancer in Nonagenarians: A Report of Five Cases

“…Recently, several reports from Japan have shown that surgery for lung cancer in elderly people, including octogenarians, was a safe and feasible treatment. [2][3][4][5][6][7][8][9][10] Moreover, the number of lung cancer cases in nonagenarians is expected to increase rapidly in the near future, and then physicians will have to deal with these patients. However, there have been few reports 11) about the strategy for lung cancer treatment including surgery, chemotherapy, and radiotherapy for nonagenarians.…”