Comparison of Elderly Patients With Younger Age Patients Who Were Diagnosed With Non-Small Cell Lung Cancer in Terms of Operability

Yıl 2019, , 114 - 126, 01.08.2019

Hüseyin Fatih Sezer , Aykut Eliçora , Aslı Gül Temel

https://doi.org/10.25279/sak.476377

Öz

Aim

Elderly patients who
were operated for non-small cell lung cancer were compared with younger age
patients in terms of their demographic characteristics, resection type,
survival, early and late postoperative complications, length of hospital stay,
and effect of older age on operability.

Materials and Methods

A total of 288 patients who underwent
resection for non-small cell lung cancer in Kocaeli University Medical Faculty
Thoracic Surgery Department were examined. Among the patients with adequate
data, 244 patients aged <70 years (Group I, control group) and 44 patients
aged >70 years (advanced age) (Group II, study group) were retrospectively
analyzed.

Results

There were no
statistically significant differences between two groups in terms of
distribution of medical history of patients (p= 0.083), and resection types (p= 0.557). A statistically significant difference
was observed between the two groups in terms of survival (p= 0.013). There was
no statistically significant difference between the two groups in terms of
postoperative early complications (p= 0.514), but there was a statistically
significant difference in terms of postoperative late complications (p= 0.034).
No statistically significant difference was observed between the two groups in
terms of postoperative discharge time (p = 0.916).

Conclusion

This study showed that
the demographic characteristics were significantly similar between the elderly
and younger patients who were treated for non-small cell lung cancer, although
there were partly statistically significant differences in terms of
postoperative morbidity and surgical treatment results. It was also observed
that advanced age alone does not constitute a contraindication for surgical
treatment.

Anahtar Kelimeler

Elderly, Lung cancer, surgery

Küçük Hücreli Dışı Akciğer Kanseri Tanılı İleri Yaş Hastaların Opere Edilebilirlik Açısından Erken Yaşlı Hastalarla Karşılaştırılması

Öz

Amaç

Küçük hücreli dışı akciğer kanseri nedeni ile opere
edilen ileri yaşlı hastaların demografik özellikler, rezeksiyon tipi, sağkalım,
erken ve geç post-op komplikasyonlar, hastanede yatış süresi açısından daha
genç yaş grubu ile karşılaştırılarak ileri yaşın opere edilebilirlik üzerindeki
etkisi araştırılmıştır.

GereçveYöntem

Kocaeli Üniversitesi Tıp Fakültesi Göğüs Cerrahisi
Anabilim Dalı tarafından küçük hücreli dışı akciğer kanseri nedeni ile
rezeksiyon yapılan 288 hasta incelendi. Verileri yeterli görülen hastalar
arasından 70 yaş altı (Grup I – Kontrol Grubu) 244 hasta ve 70 yaş ve üzeri
(ileri yaş) (Grup II – Çalışma Grubu) 44 hasta hasta geriye dönük olarak
incelendi.

Bulgular

Her iki grup arasında hastaların özgeçmişi (p=0,083)
ve rezeksiyon tipi (p=0,557) açısından istatistiksel olarak anlamlı fark
gözlenmedi. Her iki grup arasında sağkalım açısından istatistiksel olarak
anlamlı fark gözlendi (p=0,013). Her iki grup arasında post operatif erken
komplikasyon açısından istatistiksel olarak anlamlı fark görülmezken (p=0,514)
post operatif geç komplikasyon açısından istatistiksel olarak anlamlı fark
gözlendi (p=0,034). Her iki grup arasında post operatif taburculuk süresi
açısından istatistiksel olarak anlamlı fark gözlenmedi (p=0,916).

Sonuç

Çalışmamızda elde ettiğimiz sonuçlara göre; küçük
hücreli dışı akciğer kanseri nedeni ile opere edilmiş ileri yaş hastaların genç
hastalar ile benzer demografik özelliklerde olduğu, post-operatif morbidite ve
cerrahi tedavi sonuçlarında istatistiksel olarak kısmen anlamlı farklar görülse
de büyük oranda benzer olduğu saptanmıştır. Cerrahi tedavi için ileri yaşın tek
başına kontraendikasyon teşkil etmediği sonucuna varılmıştır.

Anahtar Kelimeler

İleri yaş, Akciğer kanseri, Cerrahi

Kaynakça

• Referans1 DeMatteis S, Consonni D, Bertazzi PA. Exposure to occupational carcinogens and lung cancer risk, evolution of epidemiological estimates of attributable fraction. Acta Bio Med 2008;79(1):34-42. (PMID:18924308).
• Referans2 Coultas DB, Samet JM. Occupational lung cancer. Clin Chest Med 1992;13(2):341-54. (PMID: 1511558).
• Referans3 LoCicero J, Ponn RB, Benedict DT. Lung Cancer: Surgical Treatment of Non-Small Cell Lung Cancer, In: Shields TW, LoCicero J, Ponn RB (Eds). General Thoracic Surgery. 5th edition, Lippincott Williams and Wilkins, Philadelphia, USA 2000, pp 1311-41.
• Referans4 Melek H, Medetoğlu B, Demir A, Kara V, Dinçer SI. Mortality and morbidity after surgical treatment in elderly patients with non-small cell lung cancer: the role of age. Turkish J Thorac Cardiovasc Surg 2011;19(4):586-92.
• Referans5 Detterbeck FC, Lewis SZ, Diekemper R, Addrizzo-Harris D, Alberts WM. Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians Evidence-based clinica lpractice guidelines. Chest 2013;143(5):7-37. (PMID:23649434).
• Referans6 Pagni S, McKelvey A, Riordan C, Federico JA, Ponn RB. Pulmonary resection for malignancy in the elderly: is age still a risk factor?. Eur J Cardiothorac Surg 1998;14(1):40-4. (PMID:9726613).
• Referans7 Hartz RS. Chronic Pulmonary Emboli, In: Shields TW, LoCicero J, Ponn RB (Eds). General Thoracic Surgery. 5thedition, Lippincott Williams and Wilkins, Philadelphia, USA 2000, pp 989-1000.
• Referans8 Ciriaco P, Casiraghi M, Melloni G, Carretta A, Libretti L, Augello G, et al. Pulmonary resection for non-small-cell lung cancer in patients on hemodialysis: clinical outcome and long-term results. World J Surg 2005;29(11):1516-9. (PMID:16222451).
• Referans9 Janssen-Heijnen ML, Schipper RM, Razenberg PP, Crommelin MA, Coebergh JW. Prevalence of co-morbidity in lung cancer patients and its relationship with treatment: a population-based study. Lung Cancer 1998;21(2):105-13. (PMID:9829544).
• Referans10 British TS. Society of cardio thoracic surgeons of Great Britain and Ireland working party. BTS guidelines: guidelines on theselection of patients with lung cancer for surgery. Thorax 2001;56(2):89-108. (PMID:11209097).
• Referans11 Burfeild WR Jr, Tong BC, O’Branski E, Herndon JE, Toloza EM, D'Amico TA, et al. Quality of life outcomes are equivalent after lobectomy in the elderly. J Thorac Cardiovasc Surg 2008;136(3): 597-604. (PMID:18805257).
• Referans12 Ponn RB. Complications of pulmonary resection, In: Shields TW, LoCicero J, Ponn RB, Rusch VW (Eds). General Thoracic Surgery. 6th edition, Lippincott Williams and Wilkins, Philadelphia, USA2005, pp 554-86.
• Referans13 Markos J, Mullan BP, Hillman DR, Musk AW, Antico VF, Lovegrove FT, et al. Preoperative assessment as a predictor of mortality and morbidity after lung resection. Am Rev Respir Dis 1989;139(4):902-10. (PMID:2930068).
• Referans14 Matsuoka H, Okada M, Sakamoto T, Tsubota N. Complications and outcomes after pulmonary resection for cancer in patients 80 to 89 years of age. Eur J Cardiothorac Surg 2005;28(3):380-3. ( PMID:16054820).
• Referans15 Dominguez-Ventura A, Cassivi SD, Allen MS, Wige DA, Nichols FC, Pairolero PC, et al. Lung cancer in octogenarians: factors affecting long-term survival following resection. Eur J Cardiothorac Surg 2007;32(2):370-4. ( PMID:17555978).
• Referans16 Okami J, Higashiyama M, Asamura H, Goya T, Koshiishi Y, Eguchi K, et al. Pulmonary resection in patients aged 80 years or over with clinical stage I non-small cell lung cancer: prognostic factors for over all survival and risk factors of postoperative complications. J Thorac Oncol 2009;4(10): 1247-53. (PMID:19609223).
• Referans17 Pei G, Zhou S, Han Y, Liu Z, Xu S. Risk factors for postoperative complications after lung resection for non-smallcell lung cancer in elderly patients at a single institution in China. J Thorac Dis 2014;6(9):1230–8. (PMID:25276365).
• Referans18 Thomas P, Piraux M, Jacques LF, Grégoire J, Bédard P, Deslauriers J. Clinical patterns and trends of outcome of elderly patients with bronchogenic carcinoma. Eur J Cardiothorac Surg 1998;13(3): 266-74. (PMID:9628376).
• Referans19 Oliaro A, Leo F, Filosso PL, Rena O, Parola A, Maggi G. Resection for bronchogenic carcinoma in the elderly. J Cardiovasc Surg 1999;40:715-9. (PMID: 10597010).
• Referans20 Jazieh AR, Hussain M, Howington JA, Spencer HJ, Husain M, Grismer JT, et al. Prognostic factors in patients with surgically resected stages I and II non-smallcell lung cancer. Ann Thorac Surg 2000;70(4):1168-71. ( PMID:11081863).
• Referans21 Spaggiari L, Scanagatta P. Surgery of non-small cell lung cancer in the elderly. Curr Opin Oncol 2007;19(2):84-91. (PMID:17272978).
• Referans 22 Gebitekin C, Gupta NK, Martin PG, Saunders NR, Walker DR. Long-term results in the elderly following pulmonary resection for non-smallcell lung carcinoma. Eur J Cardiothorac Surg 1993;7(12):653-6. (PMID:8129959).
• Referans23 Voltolini L, Rapicetta C, Ligabue T, Luzzi L, Scala V, Gotti G. Short- and long-term results of lung resection for cancer in octogenarians. Asian Cardiovasc Thorac Ann 2009;17(2):147-52. (PMID:19592544).
• Referans24 Razi SS, John MM, Sainathan S, Stavropoulos C. Sublobar resection is equivalent to lobectomy for T1a non-small cell lung cancer in the elderly: a surveillance, epidemiology, and end results database analysis. J Surg Res 2016;200(2):683-9. (PMID:26490227).