Are Extensive Open Lung Resections for Elderly Patients with Lung Cancer Justified?

• Published in: Current oncology (Toronto) Vol. 30; no. 6; pp. 5470 - 5484
• Main Authors: Panagopoulos, Nikolaos, Grapatsas, Konstantinos, Leivaditis, Vasileios, Galanis, Michail, Dougenis, Dimitrios
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.06.2023; MDPI
• Subjects: Aged; Aged patients; Analysis; anatomical lung resection; Cancer patients; Carcinoma, Non-Small-Cell Lung - pathology; Comorbidity; Humans; lobectomy; Lung - pathology; Lung cancer; Lung Neoplasms - pathology; Mortality; Neoplasm Staging; non-small cell lung cancer; Pneumonectomy; Retrospective Studies; Squamous cell carcinoma; Surgery; Target marketing; thoracotomy; anatomical lung resection; lung cancer; non-small cell lung cancer; lobectomy; elderly; pneumonectomy; thoracotomy
• ISSN: 1718-7729; 1198-0052; 1718-7729
• DOI: 10.3390/curroncol30060414

Older patients with malignancies are more comorbid than younger ones and are usually undertreated only because of their age. The aim of this study is to investigate the safety of open anatomical lung resections for lung cancer in elderly patients. We retrospectively analyzed all patients who underwent lung resection for lung cancer in our institution and categorized them into two groups: the elderly group (≥70 years old) and the control (<70). In total, 135 patients were included in the elderly group and 375 in the control. Elderly patients were more frequently diagnosed with squamous cell carcinoma (59.3% vs. 51.5%, = 0.037), higher differentiated tumors (12.6% vs. 6.4%, = 0.014), and at an earlier stage (stage I: 55.6% for elderly vs. 36.6%, = 0.002). Elderly patients were more vulnerable to postoperative pneumonia (3.7% vs. 0.8%, = 0.034), lung atelectasis (7.4% vs. 2.9%, = 0.040), and pleural empyema (3.2% vs. 0%, = 0.042), however, with no increased 30-day-mortality (5.2% for elderly vs. 2.7%, = 0.168). Survival was comparable in both groups (43.4 vs. 45.3 months, = 0.579). Elderly patients should not be excluded from open major lung resections as the survival benefit is not reduced in selected patients.