Abstract
Surgery for bronchogenic cancer raises the question of benefit to elderly patients.
The present study reviews a cohort of 223 patients aged 70 years and more (range:
70-84), who underwent thoracotomy for pulmonary malignancy over a 10-year period.
The aim of the study was to evaluate both operative risk and 5-year survival. Medical
history was negative in 29% of the patients; 26% had a history of cardio-vascular
disease, and 19% had a history of malignancy in complete remission. Tumor histology
was squamous-cell carcinoma for 70.4%, adenocarci-noma for 24.2%, large-cell carcinoma
for 3.6%, and small-cell carcinoma for 1.3% of the patients. 48.4% of patients were
in stage I, 17.2% in stage II, and 30.3% in stage III. Exploratory thoracotomy was
carried out in 5.8% of patients. A resection was achieved in 210 patients (pneumonectomy
in 28.5%, lobectomy in 71.5%). Operative mortality was 7.2% for the whole series,
10% after pneumonectomy and 6.6% after lobectomy. Mortality was similar below and
above 75 years. Overall 5-year survival was 32.9% (45.7% for stage I, 36.3% for stage
II, and 13.8% for stage III). Survival was not influenced by age, symptomatic or asymptomatic
presentation, medical history, and in particular not by history of malignant disease.
Although operative mortality is slightly increased when compared to younger patients,
long-term results legitimize surgery for bronchogenic cancer in the elderly.
Key words
Bronchogenic cancer - Resection - Survival rate - Age over 70 years - Prognostic factors
