Kyobu geka. The Japanese journal of thoracic surgery · 2020
[Perioperative Management for Lung Cancer in the Elderly Over 75 Years Old].
СтатьяНазвание и аннотация: Перевод в очереди
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Kato Ayumu, Yokomise Hiroyasu
Аннотация
UNLABELLED: In Japan, where the population is aging, the number of elderly lung cancer cases is expected to increase. Therefore, we retrospectively compared and examined about elderly lung cancer.
METHOD: There were 1,283 patients undergoing surgery for lung cancer between 2009 and 2018 at our institution. We classified them into 75~85 years old, 85 years old or older, and younger than 75 years, and examined the patient background, surgical procedure, and perioperative complications.
RESULT: 96.2% of 75~85 years group and 100% of 85 years old or older group had some history. There was a significant difference between the ages of 85 years old or older in PS 1 and above. There was a significant difference in limited resection between the 2 elderly groups compared to younger than 75 years group. The perioperative complication rates were 75~85 years old group (23.2%), 85 years old or older (30.9%), and younger than 75 years group (23.2%), with no significant difference. There were significant differences in postoperative delirium and chronic respiratory failure in 75~85 years group and 85 years old or older compared with younger than 75 years group. We performed a multivariate analysis of risk factors for complications. Males, PS 1 or higher, approach[ thoracotomy, video-assisted thoracic surgery (VATS)], and limited resection were considered to be independent factors. The 5-year survival rate was 70.9% in 75~85 years group, 39.3% in 85 years old or older group, and 81.0% in younger than 75 years group, and was significantly lower in 85 years old or older group.
CONCLUSION: Elderly patients need to be aware of postoperative delirium and chronic respiratory failure. It is possible that the complication rate can be reduced by performing a thorough evaluation of operative resistance and selecting an appropriate surgical procedure in the elderly.
METHOD: There were 1,283 patients undergoing surgery for lung cancer between 2009 and 2018 at our institution. We classified them into 75~85 years old, 85 years old or older, and younger than 75 years, and examined the patient background, surgical procedure, and perioperative complications.
RESULT: 96.2% of 75~85 years group and 100% of 85 years old or older group had some history. There was a significant difference between the ages of 85 years old or older in PS 1 and above. There was a significant difference in limited resection between the 2 elderly groups compared to younger than 75 years group. The perioperative complication rates were 75~85 years old group (23.2%), 85 years old or older (30.9%), and younger than 75 years group (23.2%), with no significant difference. There were significant differences in postoperative delirium and chronic respiratory failure in 75~85 years group and 85 years old or older compared with younger than 75 years group. We performed a multivariate analysis of risk factors for complications. Males, PS 1 or higher, approach[ thoracotomy, video-assisted thoracic surgery (VATS)], and limited resection were considered to be independent factors. The 5-year survival rate was 70.9% in 75~85 years group, 39.3% in 85 years old or older group, and 81.0% in younger than 75 years group, and was significantly lower in 85 years old or older group.
CONCLUSION: Elderly patients need to be aware of postoperative delirium and chronic respiratory failure. It is possible that the complication rate can be reduced by performing a thorough evaluation of operative resistance and selecting an appropriate surgical procedure in the elderly.