Surgical results and prognosis of lung cancer in elderly Japanese patients aged over 85 years: comparison with patients aged 80-84 years

Objective With the increase in lung cancer patients over 80 years of age, lobectomy with mediastinal lymph node dissection is often performed in patients in a good general condition. However, the age limit for this procedure has not yet been determined. In this study, we examined the safety, therapeutic results, and prognosis of surgical treatment for lung cancer patients over 85 years of age. Methods Among the 4446 lung cancer patients who underwent surgery at our hospital from January 1997 to March 2019, we assessed 320 patients (7.2%, Group A, aged 80-84 years) and 74 patients (1.7%, Group B, aged over 85 years). Results The median age of the patients in Group B was 86 years. Compared to Group A, Group B had significantly more patients with a history of ischemic heart disease, lower pack-year smoking, and lobectomy and lobectomy less resection (reduced surgery), and a shorter operation time (P < 0.05). There was no significant difference between the two groups in terms of postoperative complications. There was no significant difference in survival rate and prognosis between the two groups, and the 2-, 3-, and 5-year survival rates were 79.0%, 74.7%, and 53.6%, respectively, in Group B. In Group B sex (female) and early stage of cancer were independent prognostic factors of non-small cell lung cancer (stage I). Conclusions In a limited number of patients, surgical resection in patients aged over 85 years was safely performed, and the survival of these patients was comparable to those aged 80-84 years.