Artikel
Influence of Comorbidity on Outcome after Pulmonary Resection in the Elderly
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Veröffentlicht: | 22. März 2010 |
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Gliederung
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Background: The aim of this study was to determine the outcome in patients over 80 year in particular the influence of concomitant disease on short-term survival compared to younger patients.
Methods: Between 1999 and 2002, 333 patients with non small-cell lung cancer (NSCLC) were operated, in a curative intent. Patients were divided into three groups according to their age: group I, younger than 60 years; group II, between 60 und 79 years; group III, over 80 years. Co-morbidity, perioperative complications, mortality, type of resection, tumor histology and time of hospital stay, in group III were compared with those of patients in groups I and II.
Results: The operative and postoperative outcomes of group III were comparable to those of group I and II in all stages of the disease. Overall perioperative mortality was 1%. Irrespective of disease stage, major complications with re-operation were higher in groups I and II; on the other hand, minor complications occurred more frequently in group III (35% versus 16%, p <0.01). The mean hospital stay was 12 days with no significant difference between the groups. Neither the extent of resection nor co-morbidity were associated with higher complications or mortality rates. Thirty months survival rates were as follow: group I: 90%, in group II 85% and 75% in group III with no significant difference.
Conclusions: Age of the patient alone should not be considered a contraindication for lung resection. Many major complications are avoidable by careful preoperative evaluation. With proper patient selection, lung resection and even pneumonectomy may be performed with low perioperative risk and excellent results in octogenarians.