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Risk analysis of pulmonary resection for elderly patients with lung cancer.
- Source :
-
Surgery today [Surg Today] 2013 May; Vol. 43 (5), pp. 514-20. Date of Electronic Publication: 2012 Nov 04. - Publication Year :
- 2013
-
Abstract
- Purpose: The indications for pulmonary resection in elderly patients with lung cancer concomitant with another disease are unclear. We conducted this retrospective study to establish the risk factors of complications and survival to improve patient selection.<br />Methods: The subjects were 295 patients aged ≥ 75 years, who underwent pulmonary resection for lung cancer. We assessed comorbidity according to the Charlson comorbidity index (CCI) and examined risk factors for morbidity and the prognostic factors.<br />Results: Postoperative complications developed in 55 patients (morbidity 18.6 %). The median survival time was 59.3 months and the 5-year survival rate was 69.7 %. Multivariate logistic regression analyses selected smoking and thoracotomy as risk factors for complications, and a history of cerebrovascular disease, cancer stage, and thoracotomy as risk factors for a prolonged hospital stay (PHS). Video-assisted thoracic surgery (VATS) decreased the risk of morbidity and PHS, and influenced survival. Multivariate analysis with the Cox proportional hazard model identified CCI ≥ 2, morbidity, and PHS as unfavorable survival factors, in addition to age ≥ 80 and cancers that were non-adenocarcinoma or advanced.<br />Conclusions: Although CCI ≥ 2 was associated with poorer survival, it was not necessarily a risk factor of postoperative complications or PHS. Performing VATS when possible could reduce the incidence of postoperative complications and PHS in elderly patients.
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Comorbidity
Female
Humans
Incidence
Lung Neoplasms epidemiology
Male
Multivariate Analysis
Patient Selection
Postoperative Complications epidemiology
Postoperative Complications prevention & control
Prognosis
Retrospective Studies
Risk Factors
Smoking
Survival Rate
Thoracic Surgery, Video-Assisted mortality
Thoracotomy
Time Factors
Lung Neoplasms mortality
Lung Neoplasms surgery
Pneumonectomy mortality
Risk Assessment methods
Subjects
Details
- Language :
- English
- ISSN :
- 1436-2813
- Volume :
- 43
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Surgery today
- Publication Type :
- Academic Journal
- Accession number :
- 23124708
- Full Text :
- https://doi.org/10.1007/s00595-012-0401-8