Sui Xizhao, Zhao Hui, Wang Jun, Yang Feng, Yang Fan, Li Yun
Department of Thoracic Surgery, Center for Mini-Invasive Thoracic Surgery, People's Hospital, Peking University, Beijing, China.
Ann Thorac Cardiovasc Surg. 2015;21(6):529-35. doi: 10.5761/atcs.oa.15-00126. Epub 2015 Oct 6.
To analyze the short-term and long-term outcome of video-assisted thoracic surgery (VATS) lobectomy for elderly patients with non-small cell lung cancer.
105 patients aged ≥75 years with resected non-small cell lung cancer were matched with 105 younger patients by propensity score. Survival rates were calculated by the Kaplan-Meier method. The cumulative incidence functions of conditional survival rate according to the age of the patients were calculated by competing risk analysis.
patients ≥75 years was associated with higher postoperative complication rate (p <0.001), but similar perioperative death rate (p = 0.006). Patients ≥75 years were less likely to receive adjuvant chemotherapy (p <0.001). The 5-year overall survival rates were 54.6% for patients ≥75 years and 74.1% for patients <75 years (p = 0.001). No difference was seen in disease-free survival rate (59.5% vs. 71.9% respectively = 0.117). The cumulative incidence functions of 5-year cancer-specific death were similar between the two groups (28.7% vs. 24.6% respectively, p = 0.106). The cumulative incidence functions of 5-year non-cancer-specific death was significantly higher in the elderly group (18.7% vs. 1.0%, p <0.001).
VATS lobectomy for non-small-cell lung cancer in patients ≥75 years were feasible with increased morbidity but similar mortality. The resected elderly patients were more frequently associated with non-cancer-specific death.
分析电视辅助胸腔镜手术（VATS）肺叶切除术治疗老年非小细胞肺癌患者的短期和长期疗效。
采用倾向评分法将105例年龄≥75岁的非小细胞肺癌切除患者与105例年轻患者进行匹配。采用Kaplan-Meier法计算生存率。通过竞争风险分析计算根据患者年龄的条件生存率的累积发病率函数。
≥75岁患者术后并发症发生率较高（p<0.001），但围手术期死亡率相似（p = 0.006）。≥75岁患者接受辅助化疗的可能性较小（p<0.001）。≥75岁患者的5年总生存率为54.6%，<75岁患者为74.1%（p = 0.001）。无病生存率无差异（分别为59.5%和71.9%，p = 0.117）。两组5年癌症特异性死亡的累积发病率函数相似（分别为28.7%和24.6%，p = 0.106）。老年组5年非癌症特异性死亡的累积发病率函数显著更高（18.7%对1.0%，p<0.001）。
≥75岁患者行VATS肺叶切除治疗非小细胞肺癌是可行的，发病率增加但死亡率相似。老年切除患者更常与非癌症特异性死亡相关。
