Outcome of VATS Lobectomy for Elderly Non-Small Cell Lung Cancer: A Propensity Score-Matched Study

Abstract

Purpose: To analyze the short-term and long-term outcome of video-assisted thoracic surgery (VATS) lobectomy for elderly patients with non-small cell lung cancer. Methods: 105 patients aged ≥75 years with resected non-small cell lung cancer were matched with 105 younger patients by propensity score. Survival rates were calculated by the Kaplan-Meier method. The cumulative incidence functions of conditional survival rate according to the age of the patients were calculated by competing risk analysis. Results: patients ≥75 years was associated with higher postoperative complication rate (p <0.001), but similar perioperative death rate (p = 0.006). Patients ≥75 years were less likely to receive adjuvant chemotherapy (p <0.001). The 5-year overall survival rates were 54.6% for patients ≥75 years and 74.1% for patients <75 years (p = 0.001). No difference was seen in disease-free survival rate (59.5% vs. 71.9% respectively = 0.117). The cumulative incidence functions of 5-year cancer-specific death were similar between the two groups (28.7% vs. 24.6% respectively, p = 0.106). The cumulative incidence functions of 5-year non-cancer-specific death was significantly higher in the elderly group (18.7% vs. 1.0%, p <0.001). Conclusions: VATS lobectomy for non-small-cell lung cancer in patients ≥75 years were feasible with increased morbidity but similar mortality. The resected elderly patients were more frequently associated with non-cancer-specific death.

Outcomes of video‐assisted thoracoscopic surgery lobectomy in septuagenarians

“…The VATS approach obviates the need for division of chest wall muscles or rib spreading. Advocates for VATS lobectomy have previously emphasized the benefits of decreased post‐operative pain, early chest tube removal and shorter hospital stay . In the present study, we observed a significantly shorter mean hospital length of stay in the VATS group compared with the OT group.…”

“…Lung resection surgery in the elderly can be problematic due to frailty, multiple comorbidities and poor pulmonary reserve, resulting in higher rates of post‐operative morbidity . Early mortality after lung resection in elderly patients has improved in recent decades, ranging from 0% to 4.8% .…”

“…However, the rate of post‐operative morbidity after pulmonary resection remains a concern, ranging from 19.9% to 53.7% and is a significant problem, especially in this older age cohort due to its effects on patient independence and quality of life. Of the limited number of studies that do focus on the elderly population, several studies include a heterogeneous group of lung resection surgeries in their analysis, including wedge resection, segmentectomy, bilobectomy or pneumonectomy, which would have different expected post‐operative complications.…”

Kết quả bước đầu phẫu thuật nội soi cắt thùy phổi điều trị ung thư phổi nguyên phát không tế bào nhỏ tại bệnh viện Phổi trung ương

“… Các thông tin cần thu thập: [6]). Tiến tới chúng tôi thực hiện phẫu thuật nội soi cắt thuỳ phổi 1 lỗ, đây cũng là tiến bộ vượt bậc trong PTNSLN.…”

Short-and long-term outcomes of video-assisted thoracoscopic lobectomy in elderly patients with non-small-cell lung cancer

“…However, there are few studies on VATS lobectomy in elderly NSCLC patients, and majority of them only report short-term outcomes [29][30][31][32][33][34][35][36][37]. This study aimed to compare the e cacy of VATS lobectomy in elderly versus non-elderly NSCLC patients in order to explore the short-and long-term outcomes of VATS lobectomy in elderly NSCLC patients.…”