Pulmonary Resection of Non-Small Cell Lung Cancer: Is Survival in the Elderly Not Affected by Tumor Stage after Complete Resection?

Background: Lung cancer is a disease of the elderly. The aim of this study was to investigate the influence of age on the surgical treatment of non-small cell lung cancer. Methods: We retrospectively reviewed our prospective database of patients older than 75 years of age undergoing pulmonary resection in anatomic units with systematic lymph node dissection for non-small cell lung cancer. Patients were classified as follows: group I (age 75-79 years) and group 11 (age > 80 years). Morbidity, mortality and survival were analyzed in the overall collective and within both groups, respectively. Results: Between January 1999 and December 2004, 157 patients (group I: 110, group II: 47) were enrolled in this study. 104 lobectomies, 8 bilobectomies, 11 pneumonectomies, 15 sleeve resections and 19 segmentectormies were performed. For all resections mortality and morbidity were 3.8% and 38.2%, respectively. There were no significant differences in both groups. The overall 1-year and 5-year survival rates were 83% and 41%. Long-term survival was not affected by tumor stage (p = 0.234) in the present study. Conclusions: Even extended pulmonary resections for non-small cell lung cancer are feasible in the elderly. Long-term survival is obtainable. Tumor stage does not seem to play a role with regard to survival provided that complete resection of the tumor in anatomic units with systematic, extensive lymph node dissection is performed. Further investigations are necessary to prove this hypothesis in larger series.