Yellin A, Hill L R, Lieberman Y
Isr J Med Sci. 1985 Oct;21(10):833-40.
Fifty-one men and 7 women greater than 70 years of age (mean 72.3) underwent pulmonary resection over a 5-year period. Fifty-two of these patients had a malignancy, of which 48 were primary lung neoplasms, including 42 cases of non-small-cell lung cancer. The overall operative mortality rate was 10.3%. Mortality was correlated with several preoperative factors, including pulmonary function tests, arterial blood gas tension, age, extent of surgery, stage of disease, and additional systemic diseases. Only the extent of surgery (mortality of 36.4% for pneumonectomies compared with 4.3% for less extensive resections, P less than 0.01) and FEV1/VC (the ratio of forced expiratory volume in 1 sec to vital capacity) (P less than 0.05) had statistical significance. The 5-year survival rate for patients with primary lung malignancies was 40%. In view of the aggressive nature of lung tumors in any age-group, the life expectancy of greater than 10 years at age 70, and the reasonable operative risk compared with the high mortality rate in patients not operated upon, we advocate surgical treatment for most patients greater than 70 years of age with a curable disease.
在5年期间，51名男性和7名70岁以上（平均72.3岁）的女性接受了肺切除术。这些患者中有52例患有恶性肿瘤，其中48例为原发性肺肿瘤，包括42例非小细胞肺癌。总体手术死亡率为10.3%。死亡率与几个术前因素相关，包括肺功能测试、动脉血气张力、年龄、手术范围、疾病分期和其他全身性疾病。只有手术范围（全肺切除术死亡率为36.4%，而范围较小的切除术死亡率为4.3%，P<0.01）和第一秒用力呼气量与肺活量之比（FEV1/VC）（P<0.05）具有统计学意义。原发性肺恶性肿瘤患者的5年生存率为40%。鉴于肺肿瘤在任何年龄组的侵袭性、70岁时超过10年的预期寿命以及与未接受手术患者的高死亡率相比合理的手术风险，我们主张对大多数70岁以上患有可治愈疾病的患者进行手术治疗。
