Surgical treatment of non‐small cell lung cancer in patients older than seventy years

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Abstract
Surgical treatment of non‐small cell lung cancer has been reported to be associated with increased mortality, especially when pneumonectomy has been employed. A 9‐year review of 81 patients treated surgically, with a policy of avoiding pneumonectomy and using internal radiation and wedge excisions rather than lobectomy among patients with impaired reserve, resulted in an operative mortality of 4.9% compared with an overall mortality of 2.1%. Three of the four deaths were among patients older than 80 3/17 (17.6%) years so that mortality of patients 70 < age < 80 was not significantly different from overall mortality. Two of the four deaths were related to pulmonary emboli but there have been no such deaths since routine use of mini‐heparin was initiated in 1990. Five‐year survival was 42% overall, 65% for stage I, and 24% for stages II‐IIIB. We conclude that surgical treatment of patients 70 < age < 80 may be accomplished with similar mortality and survival as the overall population. Heparin prophylaxis may be especially important among patients older than 80 years.

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