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  • Title: Lung cancer in octogenarians: factors affecting morbidity and mortality after pulmonary resection.
    Author: Dominguez-Ventura A, Allen MS, Cassivi SD, Nichols FC, Deschamps C, Pairolero PC.
    Journal: Ann Thorac Surg; 2006 Oct; 82(4):1175-9. PubMed ID: 16996903.
    Abstract:
    BACKGROUND: Predictors of morbidity and mortality after pulmonary resection for lung cancer in patients 80 years of age or older are unknown. METHODS: The medical records of all patients 80 years of age or older who had pulmonary resection for lung cancer from January 1985 through September 2004 were reviewed. RESULTS: There were 379 patients (248 men, 131 women). Median age was 82 years (range, 80 to 95 years). Pneumonectomy was performed in 25 patients (6.6%), bilobectomy in 7 (1.8%), lobectomy in 240 (63.3%), segmentectomy in 29 (7.7%), and wedge excision in 78 (20.6%). The cancer was squamous cell carcinoma in 143 patients (37.7%), adenocarcinoma in 166 (43.8%), bronchoalveolar cell carcinoma in 47 (12.4%), and other in 23 (6.1%). Complications occurred in 182 patients (48.0%). These included atrial fibrillation in 75 patients, pneumonia in 27, and retained secretions requiring bronchoscopy in 37. Morbidity predictors were male sex (odds ratio [OR], 1.6), hemoptysis (OR, 2.3), and previous stroke (OR, 3.8). Asymptomatic patients had a significantly decreased probability of complications (OR, 0.56). Operative mortality was 6.3% (24 of 379); significant predictors were congestive heart failure (OR, 6.0) and prior myocardial infarction (OR, 4.3). Factors not associated with mortality included previous myocardial revascularization, renal insufficiency (creatinine >1.5 mg/dL), and diabetes mellitus. CONCLUSIONS: Pulmonary resection for lung cancer in octogenarians is feasible. Congestive heart failure and myocardial infarction, however, correlated with a significant increase in mortality. Prior myocardial revascularization, renal insufficiency, and diabetes were not associated with increased morbidity and mortality.
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