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Rivista di Chirurgia Cardiaca, Vascolare e Toracica

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The Journal of Cardiovascular Surgery 1999 October;40(5):715-9

lingua: Inglese

Resection for bron­cho­gen­ic car­ci­no­ma in the eld­er­ly

Oliaro A., Leo F., Filosso P. L., Rena O., Parola A., Maggi G.

From the Thoracic Surgery Department University of Turin, Turin, Italy


Background. The aim of ­this ­report was to ­assess post­op­er­a­tive com­pli­ca­tions, mor­tal­ity and ­long ­term sur­vi­val of sur­gi­cal ther­a­py for non ­small ­cell ­lung can­cer in ­patients ­aged 70 ­years or ­more. Results and the sig­nif­i­cance of var­i­ous prog­nos­tic fac­tors ­were ana­lysed.
Methods. At Thoracic Surgery Department of Torino, ­from January 1980 to December 1997, 258 ­patients ­aged 70 years or more were oper­at­ed on for ­lung can­cer. For the ­first 11 ­years of the ­series, ­more restric­tive selec­tion cri­te­ria ­were adopt­ed (clin­i­cal ­stage I or II ­lung can­cer, ­absence of ­major con­com­i­tant dis­ease or pre­vi­ous malig­nan­cy in the ­last 5 ­years); 60 ­patients ­were oper­at­ed in ­this peri­od. After 1990, ­such cri­te­ria ­were no long­er con­sid­ered man­da­to­ry; ­since ­then 198 ­patients ­have ­been oper­at­ed. Clinical ­data are ­reviewed in the ­seach for pre­dic­tors of mor­tal­ity and mor­bid­ity and sur­vi­val ­data are ana­lysed.
Results. Overall post­op­er­a­tive mor­tal­ity was 3.1% and mor­bid­ity was 39.1%. Pneumonectomy result­ed in high­er ­rate of mor­tal­ity (9.1%, p 0.03). Complications ­proved to be ­more fre­quent in ­patients ­with con­com­i­tant dis­ease (55.5%). Multivariate anal­y­sis on sur­vi­val ­showed the impor­tance of ­stage (5 ­years sur­vi­val was 73.6% in ­stage I, 23% in ­stage II, 8.9% in ­stage IIIa) and ­type of selec­tion (57% for the high­ly select­ed, 40% for the oth­ers).
Conclusions. Selection cri­te­ria ­have the ­same ­impact on sur­vi­val as ­stage in sur­gi­cal treat­ment of ­lung can­cer in the eld­er­ly. This fac­tor ­should be ana­lysed in ­series cov­er­ing a ­long peri­od of ­time. Low mor­tal­ity and accept­able ­long ­term sur­vi­val ­from ­this ­study con­firmed ­that sur­gery is worth­while in eld­er­ly ­patients.

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