Miyazaki Takuro, Yamasaki Naoya, Tsuchiya Tomoshi, Matsumoto Keitaro, Doi Ryoichiro, Machino Ryusuke, Nagayasu Takeshi
Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.
Ann Thorac Cardiovasc Surg. 2014;20 Suppl:497-500. doi: 10.5761/atcs.cr.13-00267. Epub 2014 Feb 4.
Lung cancer surgery in octogenarians has already become common in Japan due to the high proportion of elderly people and the progress in perioperative management, including anesthesia and video-assisted thoracic surgery. However, there have been few reports about the surgical treatment of lung cancer in nonagenarians. Five cases (mean age: 91.2 years; 3 men, 2 women) of non-small cell lung cancer in nonagenarians in whom pulmonary resection was performed are reported. All were adenocarcinomas; three were clinical stage IA, and two were IB. Three patients underwent lobectomy, and two underwent wedge resection. Mediastinal lymph node dissection was omitted in all patients. There were no fatal postoperative complications. During follow-up, one patient died due to fatal arrhythmia, and one patient who underwent wedge resection had local recurrence, but the others are alive in good condition. Pulmonary resection of lung cancer is possible for highly selected, nonagenarian patients without lymph node metastasis.
由于日本老年人口比例高以及围手术期管理（包括麻醉和电视辅助胸腔手术）的进展，肺癌手术在八旬老人中已变得很常见。然而，关于九旬老人肺癌手术治疗的报道很少。本文报告了5例（平均年龄：91.2岁；3例男性，2例女性）接受肺切除的九旬老人非小细胞肺癌病例。所有病例均为腺癌；3例为临床IA期，2例为IB期。3例患者接受了肺叶切除术，2例接受了楔形切除术。所有患者均未进行纵隔淋巴结清扫。术后无致命并发症。在随访期间，1例患者因致命性心律失常死亡，1例接受楔形切除术的患者出现局部复发，但其他患者均存活且状况良好。对于经过严格筛选、无淋巴结转移的九旬老人患者，进行肺癌肺切除是可行的。
