Feczko Andrew, McKeown Elizabeth, Wilson Jennifer L, Louie Brian E, Aye Ralph W, Gorden Jed A, Vallières Eric, Farivar Alexander S
Division of Thoracic and Foregut Surgery, Swedish Medical Center and Cancer Institute, 1101 Madison Street, Suite 900, Seattle, WA 98104, USA.
Surgical Specialists of Charlotte, 2001 Vail Ave., Suite 320, Charlotte, NC 28207, USA.
Can Respir J. 2017;2017:6294895. doi: 10.1155/2017/6294895. Epub 2017 Feb 8.
Octogenarians are at increased risk for complications after lung resection. With alternatives such as radiation, understanding the risks of surgery and associated survival are valuable. Data grading the severity of complications and long-term survival in this population is lacking. We reviewed our experience with lobectomy in octogenarians, grading complications using a validated thoracic morbidity and mortality schema. . We retrospectively reviewed consecutive patients aged ≥80 undergoing lobectomy between 2004 and 2012. Demographics, clinical/pathologic stage, complications, recurrence, and mortality were collected. Complications were graded by the Seely thoracic morbidity and mortality model. . 45 patients (mean age 82.2 years) were analyzed. The majority of patients (28/45, 62%) were clinical stage IA/IB. 62% (28/45) of patients experienced a complication. Only 15.6% (7/45) were considered significantly morbid (≥ grade IIIB) per the Seely model. Perioperative mortality was 2% and half of patients were living at a follow-up of 53 months. Overall five-year survival was 52%. . In carefully selected octogenarians, lobectomy carries a 15.6% rate of significantly morbid complications with encouraging overall survival. These data provide the basis for a more complete discussion with patients regarding lobectomy for lung cancer.
八旬老人肺切除术后并发症风险增加。鉴于存在放疗等替代方案,了解手术风险及相关生存率很有价值。目前缺乏对该人群并发症严重程度及长期生存情况进行分级的数据。我们回顾了我们在八旬老人肺叶切除方面的经验,使用经过验证的胸科发病率和死亡率模式对并发症进行分级。我们回顾性分析了2004年至2012年间连续接受肺叶切除术的年龄≥80岁的患者。收集了人口统计学资料、临床/病理分期、并发症、复发情况及死亡率。并发症根据Seely胸科发病率和死亡率模型进行分级。对45例患者(平均年龄82.2岁)进行了分析。大多数患者(28/45,62%)为临床IA/IB期。62%(28/45)的患者出现了并发症。根据Seely模型,只有15.6%(7/45)的患者被认为有严重病态(≥IIIB级)。围手术期死亡率为2%,半数患者在53个月的随访时仍存活。总体五年生存率为52%。在经过精心挑选的八旬老人中,肺叶切除术的严重病态并发症发生率为15.6%,总体生存率令人鼓舞。这些数据为与患者就肺癌肺叶切除术进行更全面的讨论提供了依据。