Morandi U, Stefani A, Golinelli M, Ruggiero C, Brandi L, Chiapponi A, Santi C, Lodi R
Department of Cardiothoracic Surgery, University of Modena, Italy.
Eur J Cardiothorac Surg. 1997 Mar;11(3):432-9. doi: 10.1016/s1010-7940(96)01084-6.
From January 1989 to October 1993, at the Department of Cardio-Thoracic Surgery of the University of Modena, 806 patients underwent thoracotomy and curative pulmonary resection for non small-cell lung cancer. Eighty five patients were 70 years old or older (mean 73.4 years, range 70-88). There were 78 males (91.7%) and 7 females (8.3%). This population was compared to 130 younger patients (under 70 years old), treated during the same period and with similar features with respect to the type of resection, sex, histology, grading and staging. Lobectomy was the procedure of preference in both groups.
As regards postoperative mortality and overall complications, no significant differences were noted between the two groups of patients (two younger patients died and 43.8% had postoperative complications; one patient of the older group died and 55.2% had postoperative complications), but in the older ones a higher incidence of cardiovascular complications was found (P < 0.01). With respect to the long-term survival (follow-up 12-70 months), no significant difference was found between the two groups.
Such findings show that pulmonary resection for bronchogenic cancer is feasible and justified in patients more than 70 years old, even if a higher incidence of cardiovascular complications may occur: a careful preoperative selection ought to be performed and lobectomy should be preferred.
1989年1月至1993年10月，在摩德纳大学心胸外科，806例患者因非小细胞肺癌接受了开胸手术及根治性肺切除术。85例患者年龄在70岁及以上（平均73.4岁，范围70 - 88岁）。其中男性78例（91.7%），女性7例（8.3%）。将该组患者与同期接受治疗、在切除类型、性别、组织学、分级和分期方面具有相似特征的130例年轻患者（70岁以下）进行比较。两组均首选肺叶切除术。
关于术后死亡率和总体并发症，两组患者之间未发现显著差异（2例年轻患者死亡，43.8%有术后并发症；老年组1例患者死亡，55.2%有术后并发症），但老年患者心血管并发症的发生率较高（P < 0.01）。关于长期生存（随访12 - 70个月），两组之间未发现显著差异。
这些结果表明，对于70岁以上的患者，即使心血管并发症的发生率可能较高，行支气管源性癌肺切除术也是可行且合理的：术前应进行仔细筛选，且应首选肺叶切除术。
