P2.15-11 Clinical Outcome of Pulmonary Resection for Non–Small Cell Lung Cancer in Extremely Elderly Patients (85-Year-Old or Over)

Abstract

Surgical resection is considered to be an effective therapy in the elderly patients. In Japan, the number of surgical operations performed in the elderly patients has been increasing. We reviewed the outcome of surgical treatment and the determining indication of pulmonary surgery in patients aged 85 years or over. We performed surgical resection for 27 lung cancer patients aged 85 years or over in our hospital from January 2007 to December 2016. The patients’ operative procedure, histological type, comorbidity, surgery-related complications, prognosis, and recurrence were retrospectively reviewed. We performed pulmonary surgery for elderly patients who have to be able to undergo pulmonary physiotherapy, have good performance status (0-1 in ECOG scale), and be free from psychological disorder such as dementia. There were 19 males and 8 females. Their mean age was 87.0 years (range: 85-93 years). The mean follow-up period after operation was 1585 days (range: 395-3255 days). Operative procedures include lobectomy (N=10), segmentectomy (N=8), and wedge resection (N=9). Histological type include adenocarcinoma (N=18), squamous cell carcinoma (N=7), adenosquamous carcinoma (N=1), and LCNEC (N=1). Pathological stage was ⅠA in 20 patients, ⅠB in 4patients, ⅡB in 2 patients, and ⅢA in 1 patient. 17 patients had comorbidity including coincidence of other malignancy, anti-coagulant therapy, history of the lobectomy, and others. No patients died from surgery or post-surgical complications. Morbidity rate was 14.8% (e.g. refractory pulmonary fistula, Atrial fibrillation, heart failure, atelectasis). 14 patients are alive, whereas 11 patients died from other diseases than lung cancer. 4 patients experienced recurrence, and 2 patients of those died. 5-year survival rate was 71.4%, and 3-year survival rate was 87.5%. Our study indicates that the surgical resection of non-small cell lung cancer benefits patients, even with extremely elder age (85-year-old or older). We consider patients with clinical stage I are good candidates. The long-term prognosis is expected if we chose the patients in elderly people lung cancer definitely.