Suemitsu Ryuichi, Yamaguchi Masafumi, Takeo Sadanori, Ondo Kaoru, Ueda Hitoshi, Yoshino Ichiro, Maehara Yoshihiko
Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, and Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Ann Thorac Cardiovasc Surg. 2008 Jun;14(3):154-60.
Surgery for elderly patients, especially those over 80 years old, with primary lung neoplasms is a relatively common treatment according to the increasing elderly population. We reviewed our experiences to evaluate surgical outcomes in over-80-year-old patients with nonsmall cell lung cancer (NSCLC).
We reviewed and analyzed the clinical records of 146 consecutive over-80-year-old patients (Group 1) and 926 control patients (65 years old and younger) (Group 2) with NSCLC who underwent surgical resections from 1981 to 2006.
The mean ages of Group 1 and Group 2 were 82.6 and 56.2 years old, respectively. The ratio of the clinical and pathological Stage I was higher than the Stages II-IV in Group 1, and that of pathological Stage III was higher in Group 2. Segmental and wedge resection were selected more frequently in Group 1, otherwise, pneumonectomy and lobectomy were selected more frequently in Group 2. The ratio of squamous cell carcinoma was higher in Group 1 than in Group 2. When we divided the time of surgeries into decades, the 1980s, 1990s, and 2000s, the ratio of elder to younger patients was clearly increased according to era: 6.6%, 13.7%, and 18.8%. Furthermore, incomplete operation cases were significantly decreased in the two groups. There was no difference of overall survival in either. When examined for overall survival, except for patients with incomplete resection, there was no significant difference between the two groups.
Surgery is the convenient treatment for elderly NSCLC patients, especially, for those who can undergo complete resection.
随着老年人口的增加,对老年患者,尤其是80岁以上的患者进行原发性肺肿瘤手术是一种相对常见的治疗方法。我们回顾了我们的经验,以评估80岁以上非小细胞肺癌(NSCLC)患者的手术结果。
我们回顾并分析了1981年至2006年间连续接受手术切除的146例80岁以上患者(第1组)和926例对照患者(65岁及以下)(第2组)的临床记录。
第1组和第2组的平均年龄分别为82.6岁和56.2岁。第1组临床和病理I期的比例高于II-IV期,而第2组病理III期的比例更高。第1组更频繁地选择肺段和楔形切除术,否则,第2组更频繁地选择全肺切除术和肺叶切除术。第1组鳞状细胞癌的比例高于第2组。当我们将手术时间按十年划分,即20世纪80年代、90年代和21世纪时,老年患者与年轻患者的比例按年代明显增加:6.6%、13.7%和18.8%。此外,两组的手术不完整病例均显著减少。两组的总生存率均无差异。在检查总生存率时,除了手术切除不完整的患者外,两组之间没有显著差异。
手术是老年NSCLC患者方便的治疗方法,尤其是对于那些能够进行完整切除的患者。