Surgical strategy for non-small cell lung cancer in octogenarians

Background and Objectives: This study was conducted to determine the optimal surgical strategy for octogenarians with non-small cell lung cancer. Methods: An observational study of 73 patients aged 80 years and over who underwent surgery for non-small cell lung cancer. Postoperative survival, mortality and morbidity were analysed. Results: The age of the patients ranged from 80 to 89 with a mean of 83. Cancer types included adenocarcinoma (n = 46), squamous cell carcinoma (n = 22) and large cell carcinoma (n = 5). Lobectomy was performed in 47 patients and limited surgery in 26. The 5-year survival rate was 57.4% in pathological stage I, 88.9% in stage II and 18.2% in stage III, respectively. The 5-year survival rate of patients with stage I disease treated by limited resection (58.8%) was similar to that of patients treated by lobectomy (54.9%). Limited resection for stage IA showed slightly better survival than lobectomy (69.4% vs 48.2%, P = 0.10), however, lobectomy was superior to limited resection for stage IB (63.2% vs 16.7%, P = 0.07). Postoperative complications occurred in 27 patients (37%) and nine patients (12%) had multiple complications. There were three postoperative deaths (4.1%). Conclusion: The early detection of the disease, hopefully in stage IA enables surgical treatment by limited resection of patients aged 80 years and over. A favourable prognosis as well as low morbidity can be anticipated in such cases.