Resection rate and operability of elderly patients with non-small cell lung cancer: Nationwide study from 1991 to 2014.

• Published in: Interactive CardioVascular and Thoracic Surgery
• Main Authors: Baldvinsson, Kristjan, Oskarsdottir, Gudrun Nina, Orrason, Andri Wilberg, Halldorsson, Hannes, Thorsteinsson, Hunbogi, Sigurdsson, Martin Ingi, Jonsson, Steinn, Gudbjartsson, Tomas
• Other Authors: 1 Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland Show the Organization-Enhanced name(s) 2 Univ Iceland, Fac Med, Reykjavik, Iceland Show the Organization-Enhanced name(s) 3 Brigham & Womens Hosp, Dept Anesthesiol, 75 Francis St, Boston, MA 02115 USA 4 Landspitali Univ, Dept Pulmonol, Reykjavik, Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: Oxford University Press 2017
• Subjects: Lungnakrabbamein; Aldraðir; Skurðlækningar; PAD12; TAS12; Aged; 80 and over; Carcinoma; Non-Small-Cell Lung; Female; Follow-Up Studies; Forecasting; Humans; Iceland; Incidence; Lung Neoplasms; Male; Neoplasm Staging; Pneumonectomy; Population Surveillance; Retrospective Studies; Survival Rate; Treatment Outcome
• Online Access: http://hdl.handle.net/2336/620336; https://doi.org/10.1093/icvts/ivw415

To access publisher's full text version of this article click on the hyperlink below An increasing number of elderly patients are diagnosed with non-small cell lung cancer (NSCLC). We compared the surgical resection rate, operability and survival in this age group (≥75 years) to younger patients using centralized databases in Iceland. The study population comprised all patients diagnosed with NSCLC in Iceland from 1991 to 2014. A total of 140 elderly patients (≥75 years) with NSCLC underwent pulmonary resection and were compared with 550 surgically resected patients less than 75 years, with respect to resection rate, short and long-term survival and complications of surgery. Reasons for exclusion from surgery were registered for elderly surgical candidates (stages IA-IIB). Surgical resection rate in the elderly group was 18% compared to 32% in the younger age group ( P < 0.001). The most frequent reasons for not operating on elderly patients in stages IA-IIB were poor pulmonary function (58%), heart disease (17%) or multiple comorbidities (17%). The rate of major complications following surgery was comparable in the elderly versus the younger age group, 13 vs 11%, respectively ( P = 0.578). The same was true for 30 day mortality (2 vs 1%, P = 0.397). Five-year overall survival was 40% vs 44% ( P = 0.019) and cancer-specific survival 51% vs 50% ( P = 0.802). Elderly patients with resectable NSCLC according to stage are frequently excluded from surgery due to comorbid conditions. Although the operated patients may represent a selected group, their favourable 30-day and long-term survival indicate that more elderly patients with NSCLC could be operated on. Landspitali University Research Fund RANNIS, The Icelandic center for Research