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Lung Cancer |

Does Age Increase Postoperative Morbidity and Mortality in Pulmonary Resection in Lung Cancer?

Ileana Palma*, MD; Silvia Quadrelli, MD; Gustavo Lyons, MD; Sebastián Lamot, MD; Marcos Hernandez, MD; Leonardo Pankl, MD; Domingo Chimondeguy, MD
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British Hospital of Buenos Aires, Buenos Aires, Argentina


Chest. 2012;142(4_MeetingAbstracts):618A. doi:10.1378/chest.1389419
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Abstract

SESSION TYPE: Lung Cancer III

PRESENTED ON: Tuesday, October 23, 2012 at 02:45 PM - 04:15 PM

PURPOSE: To analyze the clinical characteristics, postoperative morbidity and mortality in patients over 75 years old diagnosed with NSCLC undergoing a surgical procedure with curative intent.

METHODS: Retrospectively collected data was analysed, at a single center, on 593 patients undergoing lung resection for NSCLC with curative intent between January 1986 and November 2011. They were divided into 2 groups: under 75 (u75) and over 75 (o75).

RESULTS: The o75 were 47 (8%), with mean age 78.2 ± 3.2 (vs. 59.49 ± 9.04), there was no differences in sex between groups (men 61.7 vs 68.8%, p = 0.315). The o75 had a higher prevalence of previous malignancies (20 vs. 9.4%, p = 0.068) and lower proportion of smokers (including ex-smokers) (72.3 vs. 82.4%, p = 0.038). The frequency of presentation as SPN (34 vs. 38.9%, p = 0.537), right side (55.3 vs. 58.8%, p = 0.646), central location (25 vs. 26.3%, p = 1.000), asymptomatic (59.5 vs. 69%, p = 0.253) or clinical suspicion of N2 (4.3 vs. 10.4%, p = 0.299) were not different. The rate of postoperative complications (35.7% vs. 21.7% p = 0.053) or operative mortality (6.4 vs. 4.8% p = 0.498) were not different; however, in o75 less pneumonectomies were performed (4.3 vs. 16.1%, p = 0.032) and had more days in hospital intensive care (3.13 ± 8.20 vs. 1.43 ± 3.12, p = 0.003). The prevalence of tumors larger than 3 cm. (71.4 vs. 58.1%, p = 0.103), the finding of N2 disease (18.6 vs. 20.8%, p = 0.846), pleural invasion (5.5 vs. 19%, p = 0.335) or regional involvenment during surgery (42.5 vs. 31.3%, p = 0.159) were not different. Both groups had the same proportion of adenocarcinomas (68.1 vs. 61.1 p = 0.434). Surgery was considered curative in a similar percentage (89.1 vs. 86.9%, p = 0.820). The median survival was not different between both groups (37.9 vs. 70 months Kaplan-Meier log rank p = 0.064). When logistic regression was performed to find risk factors independently associated with postoperative mortality, the age over 75 does not persist in the multivariate analysis (OR 1.23 [95% CI 0.35 to 4.27], P = 0.739).

CONCLUSIONS: Our data shows that elderly patients do not have an increased morbidity and mortality after pulmonary resection.

CLINICAL IMPLICATIONS: Should not be denied lung resection based on chronological age.

DISCLOSURE: The following authors have nothing to disclose: Ileana Palma, Silvia Quadrelli, Gustavo Lyons, Sebastián Lamot, Marcos Hernandez, Leonardo Pankl, Domingo Chimondeguy

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British Hospital of Buenos Aires, Buenos Aires, Argentina

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