Port Jeffrey L, Kent Michael, Korst Robert J, Lee Paul C, Levin Matthew A, Flieder Douglas, Altorki Nasser K
Department of Cardiothoracic Surgery, Suite M404, Weill Medical College of Cornell University, 525 E 68th St, New York, NY 10021, USA.
Chest. 2004 Sep;126(3):733-8. doi: 10.1378/chest.126.3.733.
As the US population ages, clinicians are increasingly confronted with octogenarians with resectable non-small cell lung cancer. Earlier reports documented substantial risk for surgical resection in this age group.
We reviewed our surgical experience in octogenarians who underwent curative resection from 1990 to 2003.
Sixty-one patients underwent resection: 46 lobectomies, 6 segmentectomies, 5 wedge resections, and 4 pneumonectomies. There was one perioperative death (1.6%). The overall complication rate was 38% with a major complication rate of 13%. The average postoperative length of stay was 7 days. Overall 5-year survival was 38%, and 82% for stage IA patients. Patients with more advanced disease had a significantly worse survival.
Appropriately selected octogenarians with early stage disease should be offered anatomic surgical resection for cure. These patients can anticipate a long-term survival, and should not be denied an operation on the basis of age alone.
随着美国人口老龄化，临床医生越来越多地面对可切除的非小细胞肺癌的八旬老人。早期报告记录了该年龄组手术切除的重大风险。
我们回顾了1990年至2003年接受根治性切除的八旬老人的手术经验。
61例患者接受了切除手术：46例行肺叶切除术，6例行肺段切除术，5例行楔形切除术，4例行全肺切除术。围手术期死亡1例（1.6%）。总体并发症发生率为38%，主要并发症发生率为13%。术后平均住院时间为7天。总体5年生存率为38%，IA期患者为82%。疾病进展较严重的患者生存率明显较差。
对于适当选择的早期疾病八旬老人，应进行解剖性手术切除以治愈。这些患者有望长期生存，不应仅因年龄而被拒绝手术。
