Long-term results in the elderly following pulmonary resection for non-small cell lung carcinoma.
The long-term results of 647 patients undergoing pulmonary resection for non-small cell lung carcinoma (NSCLC) between 1980-1988 were reviewed. One hundred forty-five (22%) were elderly patients (70 years or more, group 1), with a mean age of 72.3 years (70-81) and the other 502 (18%) were younger (69 years or less, group 2) with a mean age of 61.4 (40-69) years. The male to female ratio was 4:1 in group 1 and 3:1 in group 2. The number of patients in group 2 (n = 234, 47%) who underwent pneumonectomy was significantly greater (P < 0.01), compared to group 1 (n = 47, 32%). Cardiopulmonary complications were more frequently observed in group 1 (19.3%) than in group 2 (7.4%), P < 0.05. Although cardiac complications (i.e. arrhythmias) were more common in the elderly group, pulmonary complications (retained secretions, atelectasis) occurred more commonly in the younger group. The overall hospital mortality in group 1 and group 2 was 8.9% and 5.3%, respectively (NS), and mortality following pneumonectomy in group 1 (10.6%) was similar to that of group 2 (7.6%) (NS). The 2- and 5-year overall actuarial survival rates were 61% and 30% in group 1 and 57% and 37% in group 2 (NS). Superior survival was achieved in patients in stage I of the disease in both groups. Cell type was not a determinant of long-term survival differences between the groups whereas type of operation (lobectomy) and sex (female) were.(ABSTRACT TRUNCATED AT 250 WORDS)