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Ann Thorac Surg 2006;82:1175-1179
© 2006 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

Lung Cancer in Octogenarians: Factors Affecting Morbidity and Mortality After Pulmonary Resection

Division of General Thoracic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota

Accepted for publication April 19, 2006.

^_* Address correspondence to Dr Allen, Division of General Thoracic Surgery, Mayo Clinic, 200 First St, SW, Rochester, MN 55905 (Email: allen.mark{at}mayo.edu).

Presented at the Poster Session of the Forty-second Annual Meeting of The Society of Thoracic Surgeons, Chicago, IL, Jan 30–Feb 1, 2006.

BACKGROUND: Predictors of morbidity and mortality after pulmonary resection for lung cancer in patients 80 years of age or older are unknown.

METHODS: The medical records of all patients 80 years of age or older who had pulmonary resection for lung cancer from January 1985 through September 2004 were reviewed.

RESULTS: There were 379 patients (248 men, 131 women). Median age was 82 years (range, 80 to 95 years). Pneumonectomy was performed in 25 patients (6.6%), bilobectomy in 7 (1.8%), lobectomy in 240 (63.3%), segmentectomy in 29 (7.7%), and wedge excision in 78 (20.6%). The cancer was squamous cell carcinoma in 143 patients (37.7%), adenocarcinoma in 166 (43.8%), bronchoalveolar cell carcinoma in 47 (12.4%), and other in 23 (6.1%). Complications occurred in 182 patients (48.0%). These included atrial fibrillation in 75 patients, pneumonia in 27, and retained secretions requiring bronchoscopy in 37. Morbidity predictors were male sex (odds ratio [OR], 1.6), hemoptysis (OR, 2.3), and previous stroke (OR, 3.8). Asymptomatic patients had a significantly decreased probability of complications (OR, 0.56). Operative mortality was 6.3% (24 of 379); significant predictors were congestive heart failure (OR, 6.0) and prior myocardial infarction (OR, 4.3). Factors not associated with mortality included previous myocardial revascularization, renal insufficiency (creatinine >1.5 mg/dL), and diabetes mellitus.

CONCLUSIONS: Pulmonary resection for lung cancer in octogenarians is feasible. Congestive heart failure and myocardial infarction, however, correlated with a significant increase in mortality. Prior myocardial revascularization, renal insufficiency, and diabetes were not associated with increased morbidity and mortality.

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