Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old
Summary: Background: An appropriate treatment of older lung cancer patients has become an important issue. The aim of this study is to evaluate the short and long-term surgical outcomes in lung cancer patients using 70 years as a cut-point, and to identify prognostic factors of cancer-specific mort...
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Elsevier
2020-01-01
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Series: | Asian Journal of Surgery |
Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958418308224 |
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DOAJ |
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English |
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Article |
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DOAJ |
author |
Apichat Tantraworasin Sophon Siwachat Narumon Tanatip Nirush Lertprasertsuke Sarawut Kongkarnka Juntima Euathrongchit Yutthaphan Wannasopha Thatthan Suksombooncharoen Busayamas Chewaskulyong Emanuela Taioli Somcharoen Saeteng |
spellingShingle |
Apichat Tantraworasin Sophon Siwachat Narumon Tanatip Nirush Lertprasertsuke Sarawut Kongkarnka Juntima Euathrongchit Yutthaphan Wannasopha Thatthan Suksombooncharoen Busayamas Chewaskulyong Emanuela Taioli Somcharoen Saeteng Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old Asian Journal of Surgery |
author_facet |
Apichat Tantraworasin Sophon Siwachat Narumon Tanatip Nirush Lertprasertsuke Sarawut Kongkarnka Juntima Euathrongchit Yutthaphan Wannasopha Thatthan Suksombooncharoen Busayamas Chewaskulyong Emanuela Taioli Somcharoen Saeteng |
author_sort |
Apichat Tantraworasin |
title |
Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old |
title_short |
Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old |
title_full |
Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old |
title_fullStr |
Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old |
title_full_unstemmed |
Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old |
title_sort |
outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old |
publisher |
Elsevier |
series |
Asian Journal of Surgery |
issn |
1015-9584 |
publishDate |
2020-01-01 |
description |
Summary: Background: An appropriate treatment of older lung cancer patients has become an important issue. The aim of this study is to evaluate the short and long-term surgical outcomes in lung cancer patients using 70 years as a cut-point, and to identify prognostic factors of cancer-specific mortality in patients older than 70 years. Methods: Medical records of non-small cell lung cancer (NSCLC) patients who underwent pulmonary resection at Chiang Mai University Hospital from January 2002 through December 2016 were retrospectively reviewed. Patients were divided into age less than 70 years (control group) and 70 years or more (study group). Primary outcomes were major post-operative complications and in-hospital death (POM); secondary outcome was long-term survival. Multivariable regression analysis was used. Results: This study included 583 patients, 167 for study group, and 416 for control group. There were no differences in POM, both at univariable and multivariable analyses, however, for long-term cancer-specific mortality, the study group was more likely to die (HRadj = 1.40, 95%CI = 1.03–1.89). Adverse prognostic factors for long-term mortality in study group were having universal coverage scheme (HRadj = 1.70, 95%CI = 1.03–2.79), the presence of intratumoral lymphatic invasion (HRadj = 2.83, 95%CI = 1.28–6.29), perineural invasion (HRadj = 2.80, 95%CI = 1.13–6.94), underwent lymph node sampling (HRadj = 2.23, 95%CI = 1.16–4.30) and higher stage of disease (HRadj = 2.02, 95%CI = 1.06–3.85 for stage III, HRadj = 3.40, 95%CI = 1.29–8.94 for stage IV). Conclusions: In-hospital mortality and composite post-operative complications are acceptable in pulmonary resection for NSCLC patients older than 70 years. However, these patients had shorter long-term survival, especially who have some adverse prognostic factors. Further studies with larger sample size are warranted. Keywords: Old age, Resectable NSCLC, Lobectomy, Prognostic factor, Propensity score |
url |
http://www.sciencedirect.com/science/article/pii/S1015958418308224 |
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AT apichattantraworasin outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT sophonsiwachat outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT narumontanatip outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT nirushlertprasertsuke outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT sarawutkongkarnka outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT juntimaeuathrongchit outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT yutthaphanwannasopha outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT thatthansuksombooncharoen outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT busayamaschewaskulyong outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT emanuelataioli outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold AT somcharoensaeteng outcomesofpulmonaryresectioninnonsmallcelllungcancerpatientsolderthan70yearsold |
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doaj-03a5c01722cd43259d32431afb95101b2020-11-24T21:25:09ZengElsevierAsian Journal of Surgery1015-95842020-01-01431154165Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years oldApichat Tantraworasin0Sophon Siwachat1Narumon Tanatip2Nirush Lertprasertsuke3Sarawut Kongkarnka4Juntima Euathrongchit5Yutthaphan Wannasopha6Thatthan Suksombooncharoen7Busayamas Chewaskulyong8Emanuela Taioli9Somcharoen Saeteng10Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand; Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Corresponding author. 110 Intawaroros Road, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandTisch Cancer Institute, Institute for Translational Epidemiology, Department of Population Health Science and Policy, Icahn Medical School at Mount Sinai, New York, NY, USADepartment of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandSummary: Background: An appropriate treatment of older lung cancer patients has become an important issue. The aim of this study is to evaluate the short and long-term surgical outcomes in lung cancer patients using 70 years as a cut-point, and to identify prognostic factors of cancer-specific mortality in patients older than 70 years. Methods: Medical records of non-small cell lung cancer (NSCLC) patients who underwent pulmonary resection at Chiang Mai University Hospital from January 2002 through December 2016 were retrospectively reviewed. Patients were divided into age less than 70 years (control group) and 70 years or more (study group). Primary outcomes were major post-operative complications and in-hospital death (POM); secondary outcome was long-term survival. Multivariable regression analysis was used. Results: This study included 583 patients, 167 for study group, and 416 for control group. There were no differences in POM, both at univariable and multivariable analyses, however, for long-term cancer-specific mortality, the study group was more likely to die (HRadj = 1.40, 95%CI = 1.03–1.89). Adverse prognostic factors for long-term mortality in study group were having universal coverage scheme (HRadj = 1.70, 95%CI = 1.03–2.79), the presence of intratumoral lymphatic invasion (HRadj = 2.83, 95%CI = 1.28–6.29), perineural invasion (HRadj = 2.80, 95%CI = 1.13–6.94), underwent lymph node sampling (HRadj = 2.23, 95%CI = 1.16–4.30) and higher stage of disease (HRadj = 2.02, 95%CI = 1.06–3.85 for stage III, HRadj = 3.40, 95%CI = 1.29–8.94 for stage IV). Conclusions: In-hospital mortality and composite post-operative complications are acceptable in pulmonary resection for NSCLC patients older than 70 years. However, these patients had shorter long-term survival, especially who have some adverse prognostic factors. Further studies with larger sample size are warranted. Keywords: Old age, Resectable NSCLC, Lobectomy, Prognostic factor, Propensity scorehttp://www.sciencedirect.com/science/article/pii/S1015958418308224 |