Lung cancer in octogenarians: factors affecting long-term survival following resection

Alberto Dominguez-Ventura, Stephen D. Cassivi, Mark S. Allen, Dennis A Wigle, Francis C. Nichols, Peter C. Pairolero, Claude Deschamps

Research output: Contribution to journalArticle

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Abstract

Objective: To identify factors associated with long-term survival following pulmonary resection for lung cancer in patients 80 years of age or older. Methods: The medical records of all patients ≥80 years, who underwent pulmonary resection for lung cancer from 1985 to 2002, were reviewed. Results: There were 294 patients (192 men, 102 women). Median age was 82 years (range 80-94 years). Overall 1-, 2-, and 5-year survival was 80%, 62%, and 34%, respectively. Histologic subtype, diabetes, renal insufficiency, prior myocardial infarction, congestive heart failure or stroke were not significantly associated with differences in 5-year survival. Female gender was associated with increased survival (36.2% vs 32.7% at 5 years, p = 0.04). Extent of preoperative forced expiratory volume in 1 s (FEV1) limitation did not influence survival. However, there were no 5-year survivors amongst patients with dyspnea as their presenting chief complaint, whereas there was a 35% 5-year survival in patients presenting without dyspnea (p < 0.001). Five-year survival by pathologic stage was IA, 48%; IB, 39%; IIA, 17%; IIB, 23%; IIIA, 9%; and IIIB, 0% (p < 0.001). Five-year survival of patients undergoing a lobectomy was 42% versus 11% for pneumonectomy (p < 0.001). Conclusions: Meaningful long-term survival is obtainable in elderly patients undergoing surgical resection for lung cancer. Careful patient evaluation and selection is necessary to identify patients who will benefit most from resection. Shorter survival was observed in male patients and those presenting with dyspnea. As could be expected, survival was also dependent on extent of resection and initial pathologic stage.

Original languageEnglish (US)
Pages (from-to)370-374
Number of pages5
JournalEuropean Journal of Cardio-thoracic Surgery
Volume32
Issue number2
DOIs
StatePublished - Aug 2007

Fingerprint

Lung Neoplasms
Survival
Dyspnea
Lung
Pneumonectomy
Forced Expiratory Volume
Patient Selection
Medical Records
Renal Insufficiency
Survivors
Heart Failure
Stroke
Myocardial Infarction

Keywords

  • Geriatric
  • Lung cancer
  • Pulmonary resection

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Dominguez-Ventura, A., Cassivi, S. D., Allen, M. S., Wigle, D. A., Nichols, F. C., Pairolero, P. C., & Deschamps, C. (2007). Lung cancer in octogenarians: factors affecting long-term survival following resection. European Journal of Cardio-thoracic Surgery, 32(2), 370-374. https://doi.org/10.1016/j.ejcts.2007.04.002

Lung cancer in octogenarians : factors affecting long-term survival following resection. / Dominguez-Ventura, Alberto; Cassivi, Stephen D.; Allen, Mark S.; Wigle, Dennis A; Nichols, Francis C.; Pairolero, Peter C.; Deschamps, Claude.

In: European Journal of Cardio-thoracic Surgery, Vol. 32, No. 2, 08.2007, p. 370-374.

Research output: Contribution to journalArticle

Dominguez-Ventura, A, Cassivi, SD, Allen, MS, Wigle, DA, Nichols, FC, Pairolero, PC & Deschamps, C 2007, 'Lung cancer in octogenarians: factors affecting long-term survival following resection', European Journal of Cardio-thoracic Surgery, vol. 32, no. 2, pp. 370-374. https://doi.org/10.1016/j.ejcts.2007.04.002
Dominguez-Ventura, Alberto ; Cassivi, Stephen D. ; Allen, Mark S. ; Wigle, Dennis A ; Nichols, Francis C. ; Pairolero, Peter C. ; Deschamps, Claude. / Lung cancer in octogenarians : factors affecting long-term survival following resection. In: European Journal of Cardio-thoracic Surgery. 2007 ; Vol. 32, No. 2. pp. 370-374.
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abstract = "Objective: To identify factors associated with long-term survival following pulmonary resection for lung cancer in patients 80 years of age or older. Methods: The medical records of all patients ≥80 years, who underwent pulmonary resection for lung cancer from 1985 to 2002, were reviewed. Results: There were 294 patients (192 men, 102 women). Median age was 82 years (range 80-94 years). Overall 1-, 2-, and 5-year survival was 80{\%}, 62{\%}, and 34{\%}, respectively. Histologic subtype, diabetes, renal insufficiency, prior myocardial infarction, congestive heart failure or stroke were not significantly associated with differences in 5-year survival. Female gender was associated with increased survival (36.2{\%} vs 32.7{\%} at 5 years, p = 0.04). Extent of preoperative forced expiratory volume in 1 s (FEV1) limitation did not influence survival. However, there were no 5-year survivors amongst patients with dyspnea as their presenting chief complaint, whereas there was a 35{\%} 5-year survival in patients presenting without dyspnea (p < 0.001). Five-year survival by pathologic stage was IA, 48{\%}; IB, 39{\%}; IIA, 17{\%}; IIB, 23{\%}; IIIA, 9{\%}; and IIIB, 0{\%} (p < 0.001). Five-year survival of patients undergoing a lobectomy was 42{\%} versus 11{\%} for pneumonectomy (p < 0.001). Conclusions: Meaningful long-term survival is obtainable in elderly patients undergoing surgical resection for lung cancer. Careful patient evaluation and selection is necessary to identify patients who will benefit most from resection. Shorter survival was observed in male patients and those presenting with dyspnea. As could be expected, survival was also dependent on extent of resection and initial pathologic stage.",
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AU - Dominguez-Ventura, Alberto

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AU - Nichols, Francis C.

AU - Pairolero, Peter C.

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N2 - Objective: To identify factors associated with long-term survival following pulmonary resection for lung cancer in patients 80 years of age or older. Methods: The medical records of all patients ≥80 years, who underwent pulmonary resection for lung cancer from 1985 to 2002, were reviewed. Results: There were 294 patients (192 men, 102 women). Median age was 82 years (range 80-94 years). Overall 1-, 2-, and 5-year survival was 80%, 62%, and 34%, respectively. Histologic subtype, diabetes, renal insufficiency, prior myocardial infarction, congestive heart failure or stroke were not significantly associated with differences in 5-year survival. Female gender was associated with increased survival (36.2% vs 32.7% at 5 years, p = 0.04). Extent of preoperative forced expiratory volume in 1 s (FEV1) limitation did not influence survival. However, there were no 5-year survivors amongst patients with dyspnea as their presenting chief complaint, whereas there was a 35% 5-year survival in patients presenting without dyspnea (p < 0.001). Five-year survival by pathologic stage was IA, 48%; IB, 39%; IIA, 17%; IIB, 23%; IIIA, 9%; and IIIB, 0% (p < 0.001). Five-year survival of patients undergoing a lobectomy was 42% versus 11% for pneumonectomy (p < 0.001). Conclusions: Meaningful long-term survival is obtainable in elderly patients undergoing surgical resection for lung cancer. Careful patient evaluation and selection is necessary to identify patients who will benefit most from resection. Shorter survival was observed in male patients and those presenting with dyspnea. As could be expected, survival was also dependent on extent of resection and initial pathologic stage.

AB - Objective: To identify factors associated with long-term survival following pulmonary resection for lung cancer in patients 80 years of age or older. Methods: The medical records of all patients ≥80 years, who underwent pulmonary resection for lung cancer from 1985 to 2002, were reviewed. Results: There were 294 patients (192 men, 102 women). Median age was 82 years (range 80-94 years). Overall 1-, 2-, and 5-year survival was 80%, 62%, and 34%, respectively. Histologic subtype, diabetes, renal insufficiency, prior myocardial infarction, congestive heart failure or stroke were not significantly associated with differences in 5-year survival. Female gender was associated with increased survival (36.2% vs 32.7% at 5 years, p = 0.04). Extent of preoperative forced expiratory volume in 1 s (FEV1) limitation did not influence survival. However, there were no 5-year survivors amongst patients with dyspnea as their presenting chief complaint, whereas there was a 35% 5-year survival in patients presenting without dyspnea (p < 0.001). Five-year survival by pathologic stage was IA, 48%; IB, 39%; IIA, 17%; IIB, 23%; IIIA, 9%; and IIIB, 0% (p < 0.001). Five-year survival of patients undergoing a lobectomy was 42% versus 11% for pneumonectomy (p < 0.001). Conclusions: Meaningful long-term survival is obtainable in elderly patients undergoing surgical resection for lung cancer. Careful patient evaluation and selection is necessary to identify patients who will benefit most from resection. Shorter survival was observed in male patients and those presenting with dyspnea. As could be expected, survival was also dependent on extent of resection and initial pathologic stage.

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KW - Lung cancer

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