A Prospective Observational Study of Pulmonary Resection for Non-small Cell Lung Cancer in Patients Older Than 75 Years

被引:4
|
作者
Yano, Tokujiro [1 ]
Kawashima, Osamu [2 ]
Takeo, Sadanori [3 ]
Adachi, Hirofumi [4 ]
Tagawa, Tsutomu [5 ]
Fukuyama, Seiichi [1 ]
Shimokawa, Mototsugu [6 ]
机构
[1] Natl Hosp Org Beppu Med Ctr, Dept Gen Thorac Surg, 1473 Uchikamado, Beppu, Oita 8740011, Japan
[2] Natl Hosp Org Shibukawa Med Ctr, Dept Chest Surg, Shibukawa, Japan
[3] Natl Hosp Org Kyushu Med Ctr, Dept Thorac Surg, Fukuoka, Japan
[4] Natl Hosp Org Hokkaido Canc Ctr, Dept Thorac Surg, Sapporo, Hokkaido, Japan
[5] Natl Hosp Org Nagasaki Med Ctr, Dept Thorac Surg, Omura, Japan
[6] Natl Hosp Org Kyushu Canc Ctr, Clin Res Inst, Canc Biostat Lab, Fukuoka, Japan
关键词
non-small cell lung cancer; surgery; elderly patients; operative morbidity; operative mortality; ACE-27; ELDERLY-PATIENTS; RISK-FACTORS; SURGERY; OCTOGENARIANS; COMORBIDITY; MORBIDITY; MORTALITY; LOBECTOMY; OUTCOMES;
D O I
10.1053/j.semtcvs.2017.05.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The operative morbidity rate in elderly patients with lung cancer is high in comparison to nonelderly patients, probably because of the increase in comorbidities that occurs with aging. However, previous reports were retrospective and were performed at single institutions; thus, the preoperative comorbidities and operative morbidity could not be fully assessed. We conducted a multi-institutional prospective observational study of elderly patients (>75 years of age) with a completely resected non–small cell lung cancer. From March 2014 to April 2015, 264 patients from 22 hospitals affiliated with the National Hospital Organization in Japan were prospectively registered in the present study. The primary end point was operative morbidity (National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0). The secondary end points were operative mortality and the risk factors for operative morbidity. Preoperative comorbidities were assessed according to the Adult Comorbidity Evaluation-27 index. The mean age at the time of surgery was 79.3 years (range 75-90 years). Forty-one percent of the patients were >80 years of age. Twenty-six percent underwent sublobar resection. The incidence of morbidities of any grade was 43.2% (90% confidence interval: 38.2%-48.2%). Respiratory system-related morbidity (19.3%), followed by cardiovascular system-related morbidity (10.2%), was the most common morbidity. The in-hospital mortality rate was 1.1% (3 of 264 patients). A multivariate analysis of the risk factors for operative morbidity showed that both Adult Comorbidity Evaluation-27 grade and the blood loss volume were significant factors. The results of the present prospective multi-institutional study should be used as a reference in the surgical treatment of elderly patients with lung cancer. © 2017 Elsevier Inc.
引用
收藏
页码:540 / 547
页数:8
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