Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old

© 2019 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 mortal...

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Main Authors: Apichat Tantraworasin, Sophon Siwachat, Narumon Tanatip, Nirush Lertprasertsuke, Sarawut Kongkarnka, Juntima Euathrongchit, Yutthaphan Wannasopha, Thatthan Suksombooncharoen, Busayamas Chewaskulyong, Emanuela Taioli, Somcharoen Saeteng
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Published: 2019
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/65818
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-658182019-08-05T04:41:41Z Outcomes of pulmonary resection in non-small cell lung cancer patients older than 70 years old Apichat Tantraworasin Sophon Siwachat Narumon Tanatip Nirush Lertprasertsuke Sarawut Kongkarnka Juntima Euathrongchit Yutthaphan Wannasopha Thatthan Suksombooncharoen Busayamas Chewaskulyong Emanuela Taioli Somcharoen Saeteng Medicine © 2019 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 (HR adj = 1.40, 95%CI = 1.03–1.89). Adverse prognostic factors for long-term mortality in study group were having universal coverage scheme (HR adj = 1.70, 95%CI = 1.03–2.79), the presence of intratumoral lymphatic invasion (HR adj = 2.83, 95%CI = 1.28–6.29), perineural invasion (HR adj = 2.80, 95%CI = 1.13–6.94), underwent lymph node sampling (HR adj = 2.23, 95%CI = 1.16–4.30) and higher stage of disease (HR adj = 2.02, 95%CI = 1.06–3.85 for stage III, HR adj = 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. 2019-08-05T04:41:41Z 2019-08-05T04:41:41Z 2019-01-01 Journal 02193108 10159584 2-s2.0-85062957867 10.1016/j.asjsur.2019.03.006 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85062957867&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/65818
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
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
description © 2019 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 (HR adj = 1.40, 95%CI = 1.03–1.89). Adverse prognostic factors for long-term mortality in study group were having universal coverage scheme (HR adj = 1.70, 95%CI = 1.03–2.79), the presence of intratumoral lymphatic invasion (HR adj = 2.83, 95%CI = 1.28–6.29), perineural invasion (HR adj = 2.80, 95%CI = 1.13–6.94), underwent lymph node sampling (HR adj = 2.23, 95%CI = 1.16–4.30) and higher stage of disease (HR adj = 2.02, 95%CI = 1.06–3.85 for stage III, HR adj = 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.
format Journal
author Apichat Tantraworasin
Sophon Siwachat
Narumon Tanatip
Nirush Lertprasertsuke
Sarawut Kongkarnka
Juntima Euathrongchit
Yutthaphan Wannasopha
Thatthan Suksombooncharoen
Busayamas Chewaskulyong
Emanuela Taioli
Somcharoen Saeteng
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
publishDate 2019
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85062957867&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/65818
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