Article
Clinical Outcomes of Thoracoscopic Lobectomy in Elderly Patients with Clinical Stage I NSCLC
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Authors
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Ruoyu Zhang
- Klinik Schillerhöhe, Abteilung für Thoraxchirurgie, Gerlingen, Deutschland
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Thomas Kyriss
- Klinik Schillerhöhe, Abteilung für Thoraxchirurgie, Gerlingen, Deutschland
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Ivonne Behrens
- Klinik Schillerhöhe, Abteilung für Thoraxchirurgie, Gerlingen, Deutschland
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Godehard Friedel
- Klinik Schillerhöhe, Abteilung für Thoraxchirurgie, Gerlingen, Deutschland
| Published: | April 21, 2016 |
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Outline
Text
Background: The proportion of elderly lung cancer patients is rising. Despite growing adoption of video-assisted thoracoscopic (VATS) lobectomy for early stage NSCLC, little is known about advantages of this minimally invasive approach for this special patient population so far.
Materials and methods: From January 2009 to July 2015, 313 patients underwent isolated VATS lobectomy for clinical stage I NSCLC in our institution. The postoperative morbidity and long-term outcome were evaluated using a partly prospective database and compared between elderly (≥70 years) and younger patients (<70 years).
Results: Patients included 137 women and 176 men, mean age was 67.0±10.0 years. There were 184 upper lobe lobectomies (58.8%), 31 middle lobe lobectomies (9.9%) and 98 lower lobe lobektomies (31.3%). The postoperative bleeding occurred in nine patients (2.9%). The perioperative mortality, overall morbidity, pulmonary and cardiac complication rate were 1.0%, 15.7%, 8.3% and 3.8%, respectively. Pathologic analysis demonstrated stage I in 247 patients (78.9%), stage II in 42 patients (13.4%), and stage III NSCLC in 24 patients (7.6%). In a follow-up period of 30.6±19.4 months, cancer recurrence and death occurred in 41 pts (13.1%) and 31 patients (9.9%), respectively. Kaplan-Meier survival analysis revealed a 5-year progression-free survival rate of 78.4%. When compared with younger patients (n=175, 55.9%), VATS lobectomy in elderly patients (n=138, 44.1%) resulted in comparable surgical and long-term outcomes except for the lower overall survival rate (see Table 1 [Tab. 1]). Similar result was seen in the 5-year progression-free survival rate for the elderly patients (80.6%) compared with the younger patients (77.1%, p=0.786, see Figure 1 [Fig. 1]).
Conclusion: Our results demonstrate that VATS lobectomy is safe and oncologically efficient for elderly patients with clinical stage I NSCLC. Increased age might not necessarily be a determinant of adverse outcomes, when lobectomy is performed via VATS.
