Surgery for lung cancer in elderly and senile patients: a ten-year experience of two centers

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OBJECTIVE

To improve the immediate results of surgical treatment for lung cancer in elderly and senile patients, by identifying the features of the postoperative course.

SUBJECTS AND METHODS

In the period from January 2012 to October 2022, a total of 520 older age group patients with lung cancer were operated in the Tomsk Region, among whom 436 (83.85%) patients were aged 60 to 75 years inclusive; the remaining 84 (16.15%) patients were within the age range of 76 to 85 years, which characterized their age as senile. At the time of hospitalization, 492 (94.62%) patients had one or more concomitant diseases, of whom 238 (45.77%) patients required preoperative correction. Surgical treatment options included extended lobectomy using a variety of techniques involving angioplasty and/or bronchoplasty, and pneumonectomy. The immediate results were assessed using the Thoracic Morbidity and Mortality System.

RESULTS

In the group of patients aged 60—75-year, adverse postoperative events were recorded in 22.25% of cases with a mortality rate of 3.9%. The patients older than 75 years had a complication rate of 70.24% and a mortality rate of 9.52%. Of these, there was a preponderance of serious complications associated with insufficient aerostasis and the presence of residual cavities, which led to additional or repeated drainage. Among the critical complications, there were most commonly different types of cardiac arrhythmias that resulted in death in 2.12% of the patients. The highest mortality rates were recorded in patients after pneumonectomy and in those with incompetence of the bronchial stump.

CONCLUSION

Lung cancer patients of this age periodization have a pronounced comorbidity that determines the features of their perioperative management and the specificity of complications. Lobar resections and lung parenchyma-sparing surgical interventions make it possible to achieve optimal immediate results of surgical treatment for lung cancer.

Keywords:

lung cancer

elderly and senile age

surgical treatment

complications

Authors:

Shefer N.A.

Tomsk Regional Oncology Dispensary

SPIN RSCI: 3662-7399
Scopus AuthorID: 57211683932
ResearcherID: HJY-1484-2023
ORCID: 0000-0002-0011-8370

Topolnitskiy E.B.

Siberian State Medical University;
Tomsk Regional Clinical Hospital;
National Research Tomsk State University

SPIN RSCI: 6744-9541
Scopus AuthorID: 35197267200
ResearcherID: T-5818-2018
ORCID: 0000-0002-5674-0177

Received:

18.10.2022

Accepted:

02.11.2022

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