Saito Zentaro, Oi Issei, Ito Takanori, Imakita Takuma, Kanai Osamu, Fujita Kohei, Mio Tadashi
Division of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Thorac Cancer. 2024 Mar;15(8):614-621. doi: 10.1111/1759-7714.15228. Epub 2024 Jan 28.
There have been several reports demonstrating the safety of flexible bronchoscopy (FB) in the elderly, but none have focused specifically on lung cancer, which is a frequent biopsy procedure.
In this study, we retrospectively evaluated the safety of FB and subsequent treatment in elderly patients with suspected primary lung cancer. Elderly patients were defined as 75 years of age or older.
A total of 141 patients, 77 in the elderly group and 64 in the nonelderly group, were reviewed. The median age of the elderly group was 80 years. Transbronchial lung biopsy was performed in more than 80% of all patients. Primary lung cancer was diagnosed in 42 (54.4%) of the elderly group and 35 (54.7%) of the nonelderly group (p = 0.38). Approximately 70% of the elderly patients with a confirmed diagnosis were treated, while more than half of the undiagnosed elderly patients had best supportive care. Complications such as bleeding, pneumothorax, fever, and pneumonia were similar in the elderly and nonelderly groups.
This study suggests that flexible bronchoscopy can be performed as safely in the elderly as in the nonelderly. Furthermore, even elderly patients may have a greater chance of receiving treatment when a definitive diagnosis is achieved.
已有多项报告证明了柔性支气管镜检查（FB）在老年人中的安全性，但尚无研究专门聚焦于肺癌这一常见的活检操作。
在本研究中，我们回顾性评估了疑似原发性肺癌老年患者的FB安全性及后续治疗情况。老年患者定义为年龄在75岁及以上。
共纳入141例患者，老年组77例，非老年组64例。老年组的中位年龄为80岁。超过80%的患者接受了经支气管肺活检。老年组42例（54.4%）诊断为原发性肺癌，非老年组35例（54.7%）诊断为原发性肺癌（p = 0.38）。确诊的老年患者中约70%接受了治疗，而未确诊的老年患者中超过一半接受了最佳支持治疗。老年组和非老年组的出血、气胸、发热和肺炎等并发症发生率相似。
本研究表明，柔性支气管镜检查在老年人中的安全性与非老年人相当。此外，即使是老年患者，在确诊后接受治疗的机会也可能更大。
