Hino Haruaki, Murakawa Tomohiro, Ichinose Junji, Nagayama Kazuhiro, Nitadori Junichi, Anraku Masaki, Nakajima Jun
Department of Thoracic Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2015;21(3):209-16. doi: 10.5761/atcs.oa.14-00160. Epub 2015 Mar 16.
Growing number of elderly lung cancer patients reflecting a lengthening life span has become a serious problem. Purpose of this study was to elucidate the short and long-term outcome of the surgery for octogenarians, and to evaluate the role of lung cancer surgery for this high age group.
The patients with lung cancer aged 80 years or more who underwent the surgery at our institute from January 1998 through December 2012 were retrospectively analyzed by chart review, and the operative mortality, morbidity and the long-term survival were assessed.
Out of a total of 1107 patients with primary lung cancer who received surgery during the study period, 94 were octogenarians (8.5%). Sixty-nine patients (73.4%) had preoperative co-morbidity including hypertension in 50 (53.2%), coincidence of other malignancy in 35 (37.2%), anti-coagulant therapy in 29 (30.9%). Twenty-six patients (27.7%) had major or minor postoperative morbidity, and one (1.1%) died due to bronchopleural fistula. Overall-5-year survival rate was 57.5%. Univariative and multivariative analysis using Cox proportional hazard model revealed that male gender and non-adenocarcinoma histology were significant risk factors for poor prognosis.
Gender and histology should be taken into account in preoperative evaluation of indication for lung cancer in octogenarians.
随着老年肺癌患者数量因寿命延长而不断增加，这已成为一个严重问题。本研究的目的是阐明八旬老人手术的短期和长期结果，并评估肺癌手术在这个高龄组中的作用。
通过病历回顾对1998年1月至2012年12月在我院接受手术的80岁及以上肺癌患者进行回顾性分析，并评估手术死亡率、发病率和长期生存率。
在研究期间接受手术的1107例原发性肺癌患者中，94例为八旬老人（8.5%）。69例患者（73.4%）术前存在合并症，其中高血压50例（53.2%），合并其他恶性肿瘤35例（37.2%），接受抗凝治疗29例（30.9%）。26例患者（27.7%）术后出现严重或轻微并发症，1例（1.1%）因支气管胸膜瘘死亡。总体5年生存率为57.5%。使用Cox比例风险模型进行的单变量和多变量分析显示，男性和非腺癌组织学是预后不良的重要危险因素。
在对八旬老人肺癌手术适应症进行术前评估时，应考虑性别和组织学因素。
