Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy

Introduction. Octogenarians are at increased risk for complications after lung resection. With alternatives such as radiation, understanding the risks of surgery and associated survival are valuable. Data grading the severity of complications and long-term survival in this population is lacking. We...

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Main Authors: Andrew Feczko, Elizabeth McKeown, Jennifer L. Wilson, Brian E. Louie, Ralph W. Aye, Jed A. Gorden, Eric Vallières, Alexander S. Farivar
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Canadian Respiratory Journal
Online Access:http://dx.doi.org/10.1155/2017/6294895
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author Andrew Feczko
Elizabeth McKeown
Jennifer L. Wilson
Brian E. Louie
Ralph W. Aye
Jed A. Gorden
Eric Vallières
Alexander S. Farivar
author_facet Andrew Feczko
Elizabeth McKeown
Jennifer L. Wilson
Brian E. Louie
Ralph W. Aye
Jed A. Gorden
Eric Vallières
Alexander S. Farivar
author_sort Andrew Feczko
collection DOAJ
description Introduction. Octogenarians are at increased risk for complications after lung resection. With alternatives such as radiation, understanding the risks of surgery and associated survival are valuable. Data grading the severity of complications and long-term survival in this population is lacking. We reviewed our experience with lobectomy in octogenarians, grading complications using a validated thoracic morbidity and mortality schema. Methods. We retrospectively reviewed consecutive patients aged ≥80 undergoing lobectomy between 2004 and 2012. Demographics, clinical/pathologic stage, complications, recurrence, and mortality were collected. Complications were graded by the Seely thoracic morbidity and mortality model. Results. 45 patients (mean age 82.2 years) were analyzed. The majority of patients (28/45, 62%) were clinical stage IA/IB. 62% (28/45) of patients experienced a complication. Only 15.6% (7/45) were considered significantly morbid (≥ grade IIIB) per the Seely model. Perioperative mortality was 2% and half of patients were living at a follow-up of 53 months. Overall five-year survival was 52%. Conclusions. In carefully selected octogenarians, lobectomy carries a 15.6% rate of significantly morbid complications with encouraging overall survival. These data provide the basis for a more complete discussion with patients regarding lobectomy for lung cancer.
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spelling doaj-art-5c63375eb467468f8a60af4e18e2e2e32025-08-20T02:05:43ZengWileyCanadian Respiratory Journal1198-22411916-72452017-01-01201710.1155/2017/62948956294895Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary LobectomyAndrew Feczko0Elizabeth McKeown1Jennifer L. Wilson2Brian E. Louie3Ralph W. Aye4Jed A. Gorden5Eric Vallières6Alexander S. Farivar7Division of Thoracic and Foregut Surgery, Swedish Medical Center and Cancer Institute, 1101 Madison Street, Suite 900, Seattle, WA 98104, USASurgical Specialists of Charlotte, 2001 Vail Ave., Suite 320, Charlotte, NC 28207, USADepartment of Surgery, Chest Disease Center, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Suite 201, Boston, MA 02215, USADivision of Thoracic and Foregut Surgery, Swedish Medical Center and Cancer Institute, 1101 Madison Street, Suite 900, Seattle, WA 98104, USADivision of Thoracic and Foregut Surgery, Swedish Medical Center and Cancer Institute, 1101 Madison Street, Suite 900, Seattle, WA 98104, USADivision of Thoracic and Foregut Surgery, Swedish Medical Center and Cancer Institute, 1101 Madison Street, Suite 900, Seattle, WA 98104, USADivision of Thoracic and Foregut Surgery, Swedish Medical Center and Cancer Institute, 1101 Madison Street, Suite 900, Seattle, WA 98104, USADivision of Thoracic and Foregut Surgery, Swedish Medical Center and Cancer Institute, 1101 Madison Street, Suite 900, Seattle, WA 98104, USAIntroduction. Octogenarians are at increased risk for complications after lung resection. With alternatives such as radiation, understanding the risks of surgery and associated survival are valuable. Data grading the severity of complications and long-term survival in this population is lacking. We reviewed our experience with lobectomy in octogenarians, grading complications using a validated thoracic morbidity and mortality schema. Methods. We retrospectively reviewed consecutive patients aged ≥80 undergoing lobectomy between 2004 and 2012. Demographics, clinical/pathologic stage, complications, recurrence, and mortality were collected. Complications were graded by the Seely thoracic morbidity and mortality model. Results. 45 patients (mean age 82.2 years) were analyzed. The majority of patients (28/45, 62%) were clinical stage IA/IB. 62% (28/45) of patients experienced a complication. Only 15.6% (7/45) were considered significantly morbid (≥ grade IIIB) per the Seely model. Perioperative mortality was 2% and half of patients were living at a follow-up of 53 months. Overall five-year survival was 52%. Conclusions. In carefully selected octogenarians, lobectomy carries a 15.6% rate of significantly morbid complications with encouraging overall survival. These data provide the basis for a more complete discussion with patients regarding lobectomy for lung cancer.http://dx.doi.org/10.1155/2017/6294895
spellingShingle Andrew Feczko
Elizabeth McKeown
Jennifer L. Wilson
Brian E. Louie
Ralph W. Aye
Jed A. Gorden
Eric Vallières
Alexander S. Farivar
Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy
Canadian Respiratory Journal
title Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy
title_full Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy
title_fullStr Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy
title_full_unstemmed Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy
title_short Assessing Survival and Grading the Severity of Complications in Octogenarians Undergoing Pulmonary Lobectomy
title_sort assessing survival and grading the severity of complications in octogenarians undergoing pulmonary lobectomy
url http://dx.doi.org/10.1155/2017/6294895
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