P3.16-28 Surgery of Stage I Non-Small Cell Lung Cancer in Patients Aged 70 Years or Older

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Non-small cell lung cancer (NSCLC) is a typical disease of the elderly patients, and is becoming increasingly. Surgical resection is standard treatment for early-stage NSCLC. The strong predictor of long-term survival for lung cancer is reported to be age. We evaluate the influence of age for stage I non- small cell lung cancer in elderly patients 70 years or older. 156 cases with stage I (UICC 8th) non-small cell lung cancer aged 70 years or more who underwent surgery at our hospital between 2007 and 2016 were studied. The patients’ medical records were reviewed with age, gender, type of operation, postoperative morbidity, postoperative mortality and survival results. There were 89 male and 67 female. The average ages were 78.2years (range, 70-90 years). The 5-year survival of all patients was 75.7%. Two groups were compared: patients aged 70 to 79 years, patients aged 80 years or more. At pathologic analysis, 74.5% and 70.7% were stage IA, 25.5% and 29.3% were stage IB. Procedure performed was lobectomy in 52.1% and 39.7%, segmentectomy in 40.8% and 39.7%, and wedge resection in 7.1% and 20.7%. Postoperative complications were documented in 12 patients (12.2%) and 11patients (19.0%) without any difference in two groups. The 30-day mortality was 0.6% , and the 90-day mortality was 0.6% . No case died for lung cancer and 14 cases (male 11) died for other disease within 5 years after lung resection in 70-79 years. The 5-year survival was 81.3%. 3 cases died for lung cancer and 12 cases (male 8) died for other disease within 5 years after lung resection in 80 years or more. The 5-year survival was 66.3%. Comparing the 5-year survival by male and female at 5 year interval were 90.0% and 90.2% in 70-74 years, 68.5% and 90.5% in 75-79 years, 61.1% and 88.9% in 80-84 years, and 82.5% and 25.0% in 85 years or more. The reason for the poor prognosis of patients in 75-79 years, 80-84 years male and 85 years or more female was that many deaths by other disease occur. Lung resection for stage I NSCLC patients in 70 years or more expected long-term survival. However, the cause of death was found to be more death from other disease than lung cancer after lung resection. We thought that the management of other disease improved the prognosis after lung resection for stage I NSCLC in elderly patients aged 70 years or older.