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老年非小细胞肺癌患者的电视辅助胸腔镜手术:一项单中心病例匹配研究

Video-assisted thoracoscopic surgery for non-small-cell lung cancer in elderly patients: a single-center, case-matched study.

作者信息

Liu Keqiang, Zhao Jing, Zhang Weiqiang, Tan Jian, Ma Jingbo, Pei Yingxin

机构信息

Department of Thoracic Surgery, General Hospital of Beijing Military Command 5 Nanmencang, Dongcheng District, Beijing 100700, People's Republic of China.

出版信息

Int J Clin Exp Med. 2015 Jul 15;8(7):11738-45. eCollection 2015.

Abstract

The incidence of non-small-cell lung cancer among elderly patients has increased; therefore, older patients are increasingly being considered for radical pulmonary resection. However, data regarding the outcome of video-assisted thoracoscopic surgery (VATS) in elderly patients are limited. The aim of this study was to evaluate the safety and feasibility of VATS in elderly patients with non-small-cell lung cancer. From January 2008 to January 2014, a total of 78 patients aged ≥ 70 years (elderly group) undergoing VATS for NSCLC were matched with 78 patients < 70 years (young group) by demographics, tumor characteristics, and details of surgical procedures. The elderly group was characterized by a higher incidence of hypertension (P = 0.001) and diabetes mellitus (P = 0.014), and ≥ 2 comorbidities (P = 0.009). Intraoperative variables, such as surgical duration blood loss, and transfusion rate, were not notably different between the groups. Postoperative 30-day mortality, 30-day complications, and 30-day major complications were comparable between the groups. The 5-year overall survival rates were 69% in the young group and 64% in the elderly group, respectively (P = 0.258). The 5-year disease-free survival rates were 65% in the young group and 60% in the elderly group, respectively (P = 0.327). Our results clearly demonstrated that VATS for non-small-cell lung cancer could be safely and efficacy performed in elderly patients; thus, advanced age itself should not be regarded as a contraindication for VATS.

摘要

老年患者非小细胞肺癌的发病率有所上升;因此,越来越多的老年患者被考虑进行根治性肺切除术。然而,关于老年患者电视辅助胸腔镜手术(VATS)结果的数据有限。本研究的目的是评估VATS在老年非小细胞肺癌患者中的安全性和可行性。2008年1月至2014年1月,共有78例年龄≥70岁(老年组)的非小细胞肺癌患者接受了VATS手术,并根据人口统计学、肿瘤特征和手术细节与78例年龄<70岁(年轻组)的患者进行匹配。老年组的特点是高血压(P = 0.001)和糖尿病(P = 0.014)的发病率较高,以及≥2种合并症(P = 0.009)。两组之间的术中变量,如手术时间、失血量和输血率,没有显著差异。两组之间的术后30天死亡率、30天并发症和30天主要并发症相当。年轻组和老年组的5年总生存率分别为69%和64%(P = 0.258)。年轻组和老年组的5年无病生存率分别为65%和60%(P = 0.327)。我们的结果清楚地表明,老年非小细胞肺癌患者可以安全有效地进行VATS手术;因此,高龄本身不应被视为VATS的禁忌症。

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