Lung Cancer in Octogenarians: Factors Affecting Morbidity and Mortality After Pulmonary Resection.
From: Division of General Thoracic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
The Annals of thoracic surgery
- Publish Date: Oct 2006
- ISSN: 1552-6259
- Volume: 82
- Issue: 4
- Pages: 1175-9
- Medium: Internet
- Language: English
- Citation (JAMA): Dominguez-Ventura Alberto, Allen Mark S, Cassivi Stephen D, et al. Lung Cancer in Octogenarians: Factors Affecting Morbidity and Mortality After Pulmonary Resection.. Ann. Thorac. Surg. Oct 2006;82:1175-9
Abstract
BACKGROUND: Predictors of morbidity and mortality after pulmonary resection for lung cancer in patients 80 years of age or older are unknown. METHODS: The medical records of all patients 80 years of age or older who had pulmonary resection for lung cancer from January 1985 through September 2004 were reviewed. RESULTS: There were 379 patients (248 men, 131 women). Median age was 82 years (range, 80 to 95 years). Pneumonectomy was performed in 25 patients (6.6%), bilobectomy in 7 (1.8%), lobectomy in 240 (63.3%), segmentectomy in 29 (7.7%), and wedge excision in 78 (20.6%). The cancer was squamous cell carcinoma in 143 patients (37.7%), adenocarcinoma in 166 (43.8%), bronchoalveolar cell carcinoma in 47 (12.4%), and other in 23 (6.1%). Complications occurred in 182 patients (48.0%). These included atrial fibrillation in 75 patients, pneumonia in 27, and retained secretions requiring bronchoscopy in 37. Morbidity predictors were male sex (odds ratio [OR], 1.6), hemoptysis (OR, 2.3), and previous stroke (OR, 3.8). Asymptomatic patients had a significantly decreased probability of complications (OR, 0.56). Operative mortality was 6.3% (24 of 379); significant predictors were congestive heart failure (OR, 6.0) and prior myocardial infarction (OR, 4.3). Factors not associated with mortality included previous myocardial revascularization, renal insufficiency (creatinine >1.5 mg/dL), and diabetes mellitus. CONCLUSIONS: Pulmonary resection for lung cancer in octogenarians is feasible. Congestive heart failure and myocardial infarction, however, correlated with a significant increase in mortality. Prior myocardial revascularization, renal insufficiency, and diabetes were not associated with increased morbidity and mortality.
Mesh Headings (Keywords): Adenocarcinoma, Aged, 80 and over, Carcinoma, Squamous Cell, Comorbidity, Female, Heart Failure, Humans, Lung Neoplasms, Male, Myocardial Infarction, Pneumonectomy, Risk Factors
Check for Full Text / PubMed Unique Identifier (PMID): 16996903
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