Although resection offers the best chance of cure for most solid tumours, including the lung, <2% of elderly patients (>80 age years) undergo this treatment often because of their perceived frailty and complication rates. Since lung cancer is a disease of the elderly, with up to 30% occurring in this age group, we were interested to review the results of attempted curative resection in older patients referred to our tertiary thoracic surgical unit.Methods
We reviewed the medical records of all 1481 patients aged 60 or older who had undergone single or bi-lobectomy with curative intent from 2001 to 2008, and divided them into age groups 60–79 (1360 cases, 663 female) and 80+ (121, 41). We looked at their clinical parameters, and then compared the results of surgery in terms of short-term mortality, complication rates, and length of stay.Results
The older patients had smoked less (median 30 pack years [IQR 20–50] vs 40 [20–54], p<0.5), and had better lung function (FEV1 88% [73–103] vs 81% [66–93], p<0.001), but had more heart disease (41% vs 29%, p<0.001). Postoperative results are given in the Abstract P192 table 1.Conclusion
Although the older patients had more postoperative complications, 94% survived the procedure, indicating that surgical resection with curative intent is a viable proposition in selected cases of lung cancer in the elderly. Thus, age should not be a bar to surgical treatment in the older age group, and this study reiterates the need to consider potentially curative surgery for all age groups with this life threatening disease.