The Feasibility of Thoracotomy for Lung Cancer in the Elderly FREE

Stanley Sherman, MD, FCCP; Carolyn E. Guidot, MD

[+] Author Affiliations

Read in part before the annual meeting of the American Thoracic Society, Kansas City, Mo, May 14, 1986.

Reprint requests to Pulmonary Division, Department of Internal Medicine, William Beaumont Hospital, 3535 W 13 Mile Rd, Suite 502, Royal Oak, MI 48072 (Dr Sherman).

JAMA. 1987;258(7):927-930. doi:10.1001/jama.1987.03400070065036

Text Size: A A A

This article was corrected | View correction

Published online

Article

References

ABSTRACT

ABSTRACT | REFERENCES

We reviewed 139 cases of thoracotomy for lung cancer, performed during a 7 1/2-year period. Patients were divided into two groups based on age: a younger group (<70 years old) and an elderly group (≥70 years old). Among all cases of lung cancer diagnosed during the study period, the percentage of patients undergoing thoracotomy in both groups was comparable. Comparison of baseline features of the two groups revealed no statistical difference in the distribution of sex, smoking history, arterial blood gas values, degree of airflow obstruction, cell type, stage of cancer, or subsequent therapy. Potentially serious medical problems were more frequent in the elderly group, whereas the younger group had significantly higher values for several pulmonary function parameters and underwent a significantly higher proportion of pneumonectomies. Although operative mortality in the elderly group was greater (9.4% vs 4.0%; 95% confidence intervals, 29.9%, 92.5% vs 7.5%, 70.1%), further analysis of outcomes revealed no statistically significant difference in the postoperative complications, postoperative hospital stay, or actuarial survival. We conclude that advanced age does not adversely affect prognosis following thoracotomy for lung cancer. Therefore, elderly patients with reasonable cardiopulmonary function should not be denied potentially curative pulmonary resection because of concern for age-related complications.

(JAMA 1987;258:927-930)

REFERENCES

ABSTRACT | REFERENCES

Weiss W: Operative mortality and five-year survival rates in patients with bronchogenic carcinoma . Am J Surg 1974;;128:799-804.

Nagasaki, F, Flehinger BJ, Martini N: Complications of surgery in the treatment of carcinoma of the lung . Chest 1982;;82:25-29.

Bourgeon A, Richelme H, Lalanne CM, et al: Actuarial survival after surgery for 350 patients with bronchial carcinoma . Int J Radiat Oncol Biol Phys 1980;;6:1021-1027.

Rostad H, Vale JR, Lexow P: Survival in lung cancer after surgery . Scand J Respir Dis 1979;;79: 297-302.

Sensenig DM, Rossi NP, Ehrenhaft JL: Pulmonary resection for bronchogenic carcinoma in geriatric patients . Ann Thorac Surg 1966;;2:508-513.

Harviel JD, McNamara JJ, Straehley CJ: Surgical treatment of lung cancer in patients over the age of 70 years . J Thorac Cardiovasc Surg 1978;;75: 802-805.

Kirsh MM, Rotman H, Bove E, et al: Major pulmonary resection for bronchogenic carcinoma in the elderly . Ann Thorac Surg 1976;;22:369-373.

Yashar J, Yashar JJ: Factors affecting long-term survival of patients with bronchogenic carcinoma . Am J Surg 1975;;129:386-393.

Paulson DL, Reisch JS: Long-term survival after resection for bronchogenic carcinoma . Ann Surg 1976;;76:324-332.

Statistical Abstract of the United States . US Dept of Commerce, 1981;.

Carr DT: The staging of lung cancer . Am Res Respir Dis 1978;;117:819-823.

Mantel N: Evaluation of survival data and two new rank-order statistics arising in its consideration . Cancer Chemother Rep 1966;;50:163-170.

Goodman LA: On simultaneous confidence intervals for multinomial proportions . Technometrics 1965;;7:247-254.

Mace AE: Sample Size Determination . Melbourne, Fla, Robert E Krieger Publishing Co Inc, 1974;, pp 110-113.

Bates M: Results of surgery for bronchial carcinoma in patients aged 70 and over . Thorax 1970;;25:77-78.

Breyer RH, Zippe C, Pharr WF, et al: Thoracotomy in patients over age 70 years: Ten-year experience . J Thorac Cardiovasc Surg 1981;;81: 187-193.

Thompson-Evans EW: Resection for bronchial carcinoma in the elderly . Thorax 1973;;28:86-88.

Shields TW, Humphrey EW, Higgins GA, et al: Long-term survivors after resection of lung carcinoma . J Thorac Cardiovasc Surg 1978;;76:439-445.

Yellin A, Benfield JR: Surgery for bronchogenic carcinoma in the elderly . Am Rev Respir Dis 1985;;131:197.

Ginsberg RJ, Hill LD, Eagan RT, et al: Modern 30-day operative mortality for surgical resections in lung cancer . J Thorac Cardiovasc Surg 1983;;86: 654-658.

Gass GD, Olsen GN: Preoperative pulmonary function testing to predict postoperative morbidity and mortality . Chest 1986;;89:127-135.

Goldman L: Cardiac risks and complications of noncardiac surgery . Ann Intern Med 1983;;98:504-513.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal