TY - JOUR
T1 - Lung Cancer in Octogenarians
T2 - Factors Affecting Morbidity and Mortality After Pulmonary Resection
AU - Dominguez-Ventura, Alberto
AU - Allen, Mark S.
AU - Cassivi, Stephen D.
AU - Nichols, Francis C.
AU - Deschamps, Claude
AU - Pairolero, Peter C.
PY - 2006/10
Y1 - 2006/10
N2 - 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.
AB - 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.
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U2 - 10.1016/j.athoracsur.2006.04.052
DO - 10.1016/j.athoracsur.2006.04.052
M3 - Article
C2 - 16996903
AN - SCOPUS:33748744867
SN - 0003-4975
VL - 82
SP - 1175
EP - 1179
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 4
ER -