Surgery for lung cancer in the elderly

In order to assess the appropriateness of lung cancer surgery in the elderl y and determine optimal subjects and resection procedure, 75 patients opera ted on in 1976-1996 at age greater than or equal to 75 years (including 13 greater than or equal to 80) were followed up. The operations included limi ted resection (8), lobectomy (47), bilobectomy (10) and pneumonectomy (10) and were judged to be radical in 59 cases (79%). Perioperative mortality wa s 9% and morbidity 29%, including 21% major complications. Cumulative 5-yea r survival was 32%, in stages IA-IIB 27-41%, and cancer-related survival 61 -79%. Mortality did not differ significantly between resection types, but m orbidity did. Nor did mortality, morbidity or survival differ between the a ge groups 75-79 and greater than or equal to 80 years. In stage I cancer th ere was no significant difference in survival or cancer-related survival af ter lobectomy vs limited resection. We conclude that age, even greater than or equal to 80 years, is not incompatible with curative resection. Lobecto my is the treatment of choice, but a less radical resection may be advisabl e if there is comorbidity. If more extensive resection is performed, the in dividual surgical risk must be weighed against the potential long-term bene fit.