P. Thomas et al., IS LUNG-CANCER RESECTION JUSTIFIED IN PATIENTS AGED OVER 70 YEARS, European journal of cardio-thoracic surgery, 7(5), 1993, pp. 246-250
From January 1980 through January 1985, 452 consecutive patients under
went pulmonary resection for primary non-small cell bronchogenic cance
r. Forty-seven patients (10.4%) were 70 years old or older: there were
45 men and 2 women, with a mean age of 72.4 years (S.D.: 2.6; range:
70-79). This population was comparable to the 405 younger patients wit
h respect to the type of resection, histology and TNM staging. Whereas
the non-fatal complication rate was similar in both groups (25.5% ver
sus 29.9%), the in-hospital mortality rate was significantly higher in
the older patients (12.8% versus 4.7%; P less-than-or-equal-to 0.05).
The mortality rate after extended resections was significantly higher
among the older patients (33.3% versus 6%, P less-than-or-equal-to 0.
01). The cause of death was myocardial infarction in half the cases; t
he underlying coronary disease was unrecognized preoperatively in one-
third. Five-year survival was comparable in both groups: 29.8% and 33%
, respectively. We conclude that pulmonary resection for bronchogenic
cancer is justified in patients over 70 years; a careful preoperative
assessment ought to be performed and standard resections should be pre
ferred.