A retrospective analysis of short and long-term survival after curative pulmonary resection for lung cancer in elderly patients

In this retrospective study we analyzed the age-related mortality and the long-term survival of a total of 2021 subjects (male: n = 1509; female: n = 512) who underwent major pulmonary resections (lobectomy, pneumonectomy) in curative intention for primary non-small cell lung cancer (NSCLC). As controls, patients were divided into three groups of age: subjects >75 years of age (n = 119), subjects 65-75 years of age (n = 587) and subjects <65 years of age (n = 1315). Overall mortality after lobectomy was 1.4% (21/1505 patients); age-related mortality was 0.9% (n = 8/919) in subjects aged <65 years, 1.9% (n = 9/486) in subjects aged 65-75 years, and 4.0% (n = 4/100) in subjects aged >75 years. Overall mortality after pneumonectomy was 4.3% (22/516 patients); age-related mortality was 3.0% (n = 12/396) in subjects aged <65 years, 7.9% (n = 8/101) in subjects aged 65-75 years, 10.5% (n = 2/19) in subjects aged >75 years. The overall 5-year survival rates were 52.5% (age: <65 years), 45.8% (age: 65-75 years), and 50% (age: >75 years). There was no significant difference in overall survival between age groups. However, an impaired performance status (ECOG status grades 1-3) had a significant negative impact on survival in subjects >65 years (p = 0.017), and in subjects >75 years (p = 0.002). We conclude, medically fit elderly patients should not be denied surgery of resectable non-small cell lung cancer based on their chronologic age alone. Curative pulmonary resections due to lung cancer can be performed safely in those elderly patients that are fulfilling the common criteria of operability.