Ollila Hely, Tidjani Amina, Park Bernard J, Jones David R, Adusumilli Prasad S
Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States.
Lung Cancer. 2025 Aug;206:108632. doi: 10.1016/j.lungcan.2025.108632. Epub 2025 Jun 24.
An increasing number of nonagenarians are being referred to thoracic surgery clinics for the treatment of non-small cell lung cancer (NSCLC). However, discussions with the patient about surgical resection as a treatment option and the related informed consent process are constrained by the lack of specific information regarding perioperative and short- and long-term outcomes after surgery in this cohort of patients.
We retrospectively identified patients aged ≥90 years who underwent surgical resection for NSCLC at Memorial Sloan Kettering Cancer Center from 2001 to 2021. Risks, complications, and outcomes related to surgical treatment, including neurocognitive complications, length of stay, readmissions, mortality, and survival, were assessed.
During the study period, 17 nonagenarian patients underwent surgical resection for NSCLC at our center; 15 of these patients (88%) received geriatric and/or cardiology consultation before surgery. Fourteen patients (82%) experienced minor complications; however, evidence of postoperative neurocognitive status compromise was not observed. Median length of stay was 5 days; 3 patients (18%) were readmitted within 90 days of discharge. No patients died within 30 or 90 days of surgical resection. Median overall survival was 43 months.
Outcomes among nonagenarian patients who were selected to undergo surgical resection for NSCLC were positive, with overall survival approaching that of the general population of 90-year-olds. The data from this study can enrich the informed consent discussion with nonagenarian patients who are candidates for surgical resection for NSCLC.
越来越多的九旬老人因非小细胞肺癌（NSCLC）被转诊至胸外科诊所接受治疗。然而，由于缺乏关于该患者群体围手术期以及手术短期和长期结果的具体信息，与患者讨论手术切除作为一种治疗选择以及相关的知情同意过程受到限制。
我们回顾性地确定了2001年至2021年在纪念斯隆凯特琳癌症中心接受NSCLC手术切除的年龄≥90岁的患者。评估了与手术治疗相关的风险、并发症和结果，包括神经认知并发症、住院时间、再次入院、死亡率和生存率。
在研究期间，17名九旬老人在我们中心接受了NSCLC手术切除；其中15名患者（88%）在手术前接受了老年病科和/或心脏病科会诊。14名患者（82%）出现了轻微并发症；然而，未观察到术后神经认知状态受损的证据。中位住院时间为5天；3名患者（18%）在出院后90天内再次入院。没有患者在手术切除后30天或90天内死亡。中位总生存期为43个月。
被选择接受NSCLC手术切除的九旬老人患者的预后良好，总生存期接近90岁普通人群。本研究的数据可以丰富与NSCLC手术切除候选九旬老人患者的知情同意讨论。
