The risk of pneumonectomy over the age of 70. A case–control study☆

Abstract

In the elderly patients, the risk of respiratory complications after pneumonectomy is increased as compared to younger patients with equivalent respiratory function. Age and preoperative chemotherapy are independent risk factors for respiratory complications. A lower mortality and a better long-term survival are obtained in elderly patients with a better respiratory function (FEV1>or=70%).

A retrospective analysis of short and long-term survival after curative pulmonary resection for lung cancer in elderly patients

“…This is in concordance with the experience reported by Leo et al In their series, the occurrence of pulmonary complications was the only predictor for postoperative death [31]. After pneumonectomy, however, coronary artery disease may be seen as the main risk factor of 30-day operative mortality for patients aged >70 years [32].…”

“…In contrast to this, Yamamoto and colleagues found no difference in survival of elderly patients compared with younger ones in stage I NSCLC [33]. Leo et al reported a significant difference between the age groups with 17.5% in 5-year survival of patients aged above 70 years and 53.6% in patients aged below 70 years [31]. In our series as in most papers survival is defined as overall survival, as the information on cancer-related death is usually very limited because of lacking information, and due to autopsy being performed in few cases.…”

Dose intensity correlate with survival in elderly patients treated with chemotherapy for advanced non-small cell lung cancer

“…Unfortunately, among oncologists often still stands the opinion that in the elderly dose intensity may mean heavy toxicity rather than efficacy, a belief frequently leading to unjustified chemotherapy undertreatment. Undoubtedly, due to comorbidities, polypharmacy and compromised organ function, this population is a challenging one but an accurate pre-treatment assessment and the use of patient-adapted regimens can favor the achievement of a good clinical response with low morbidity and mortality [17,19,20]. According to our data, baseline hemoglobin and BMI significantly impact on delivered RDI; as also suggested by the literature, nutritional deficit as well as even mild anemia must be promptly managed in elderly patients candidates to chemotherapy [21,22].…”

Preoperative Evaluation of the Older Patient

“…More importantly, overwhelming evidence suggests that quality of life can be maintained or improved following surgery [4][5][6][7]. However, despite these positive results, age remains a risk factor for postoperative morbidity [8,9] and mortality [10,11]. This reminds us that there is room for quality improvement, a large part of which involves careful preoperative assessment and interventions uniquely fitted to the needs of geriatric surgical patients.…”