Lung Cancer in Octogenarians: Factors Affecting Morbidity and Mortality After Pulmonary Resection

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

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)1175-1179
Number of pages5
JournalAnnals of Thoracic Surgery
Volume82
Issue number4
DOIs
StatePublished - Oct 2006

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Lung Neoplasms
Morbidity
Lung
Mortality
Odds Ratio
Myocardial Revascularization
Renal Insufficiency
Heart Failure
Myocardial Infarction
Segmental Mastectomy
Pneumonectomy
Hemoptysis
Sex Ratio
Bronchoscopy
Atrial Fibrillation
Medical Records
Squamous Cell Carcinoma
Creatinine
Pneumonia
Diabetes Mellitus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Dominguez-Ventura, A., Allen, M. S., Cassivi, S. D., Nichols, F. C., Deschamps, C., & Pairolero, P. C. (2006). Lung Cancer in Octogenarians: Factors Affecting Morbidity and Mortality After Pulmonary Resection. Annals of Thoracic Surgery, 82(4), 1175-1179. https://doi.org/10.1016/j.athoracsur.2006.04.052

Lung Cancer in Octogenarians : Factors Affecting Morbidity and Mortality After Pulmonary Resection. / Dominguez-Ventura, Alberto; Allen, Mark S.; Cassivi, Stephen D.; Nichols, Francis C.; Deschamps, Claude; Pairolero, Peter C.

In: Annals of Thoracic Surgery, Vol. 82, No. 4, 10.2006, p. 1175-1179.

Research output: Contribution to journalArticle

Dominguez-Ventura, A, Allen, MS, Cassivi, SD, Nichols, FC, Deschamps, C & Pairolero, PC 2006, 'Lung Cancer in Octogenarians: Factors Affecting Morbidity and Mortality After Pulmonary Resection', Annals of Thoracic Surgery, vol. 82, no. 4, pp. 1175-1179. https://doi.org/10.1016/j.athoracsur.2006.04.052
Dominguez-Ventura, Alberto ; Allen, Mark S. ; Cassivi, Stephen D. ; Nichols, Francis C. ; Deschamps, Claude ; Pairolero, Peter C. / Lung Cancer in Octogenarians : Factors Affecting Morbidity and Mortality After Pulmonary Resection. In: Annals of Thoracic Surgery. 2006 ; Vol. 82, No. 4. pp. 1175-1179.
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abstract = "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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AU - Dominguez-Ventura, Alberto

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AU - Cassivi, Stephen D.

AU - Nichols, Francis C.

AU - Deschamps, Claude

AU - Pairolero, Peter C.

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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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