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Resection rate and operability of elderly patients with non-small cell lung cancer: Nationwide study from 1991 to 2014.

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Authors
Baldvinsson, Kristjan
Oskarsdottir, Gudrun Nina
Orrason, Andri Wilberg
Halldorsson, Hannes
Thorsteinsson, Hunbogi
Sigurdsson, Martin Ingi
Jonsson, Steinn
Gudbjartsson, Tomas
Issue Date
2017-05-01

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Citation
Resection rate and operability of elderly patients with non-small cell lung cancer: Nationwide study from 1991 to 2014. 2017, 24 (5):733-739 Interact Cardiovasc Thorac Surg
Abstract
An increasing number of elderly patients are diagnosed with non-small cell lung cancer (NSCLC). We compared the surgical resection rate, operability and survival in this age group (≥75 years) to younger patients using centralized databases in Iceland.
The study population comprised all patients diagnosed with NSCLC in Iceland from 1991 to 2014. A total of 140 elderly patients (≥75 years) with NSCLC underwent pulmonary resection and were compared with 550 surgically resected patients less than 75 years, with respect to resection rate, short and long-term survival and complications of surgery. Reasons for exclusion from surgery were registered for elderly surgical candidates (stages IA-IIB).
Surgical resection rate in the elderly group was 18% compared to 32% in the younger age group ( P <  0.001). The most frequent reasons for not operating on elderly patients in stages IA-IIB were poor pulmonary function (58%), heart disease (17%) or multiple comorbidities (17%). The rate of major complications following surgery was comparable in the elderly versus the younger age group, 13 vs 11%, respectively ( P =  0.578). The same was true for 30 day mortality (2 vs 1%, P =  0.397). Five-year overall survival was 40% vs 44% ( P =  0.019) and cancer-specific survival 51% vs 50% ( P =  0.802).
Elderly patients with resectable NSCLC according to stage are frequently excluded from surgery due to comorbid conditions. Although the operated patients may represent a selected group, their favourable 30-day and long-term survival indicate that more elderly patients with NSCLC could be operated on.
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ae974a485f413a2113503eed53cd6c53
10.1093/icvts/ivw415
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