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Worsened long-term outcomes and postoperative complications in octogenarians with lung cancer following mediastinal lymph-node dissection

^a Department of Thoracic Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan
^b Department of Chest Surgery, Ohta-Nishinouchi Hospital, Japan
^c Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Japan

*Corresponding author. Tel.: +81-282-87-2160; fax: +81-282-86-6390.

E-mail address: chida-ths{at}umin.ac.jp (M. Chida).

We evaluated the effects of mediastinal lymph-node dissection on outcomes in octogenarians with primary lung cancer. Outcomes and postoperative complications were retrospectively investigated in 48 octogenarians with anatomically resected lung cancer, of whom 23 underwent a mediastinal lymph-node dissection (ND2 group) and 25 a limited lymphadenectomy (ND0-1 group). Forty-three patients underwent a lobectomy, two a pneumonectomy, and three a segmentectomy. The five-year survival rate for all was 35%, while that for those in pathological stage I was 43.3% and for those in stage II+III was 21.2%. As for lymph node dissection, the five-year survival rate for the ND0-1 group (54.3%) was superior to that for the ND2 group (21.7%) (P=0.022). For patients in pathological stage I, those rated ND0-1 had a better five-year survival than those rated ND2 (61.9% vs. 28.6%) (P=0.041). In addition, mediastinal lymph-node dissection increased the incidence of postoperative cardiac complications (P=0.004). Our results indicate that major pulmonary resection with mediastinal lymph-node dissection is associated with a higher rate of mortality in octogenarians with lung cancer.

Key Words: Lung cancer; Octogenarian; Elderly; Complication

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