This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Nikolaos Barbetakis Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Barbetakis, N. Articles by Tsilikas, C. Search for Related Content PubMed PubMed Citation Articles by Barbetakis, N. Articles by Tsilikas, C. Related Collections Related Article

eComment: Long-term outcomes in octogenarians with lung cancer following mediastinal lymph node dissection

Thoracic Surgery Department, Theagenio Cancer Hospital, A. Simeonidi 2, 54007 Thessaloniki, Greece

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

We would like to congratulate Dr Chida et al. for their excellent analysis regarding the impact of mediastinal lymph node dissection on the outcome and postoperative complications in octogenarians [1].

Age is a recognized risk factor for death after thoracotomy in elderly patients with lung cancer. Among other factors, the genesis of this risk is the physiologic debilitation that occurs after division of respiratory muscles during thoracotomy, as well as the loss of lung tissue after lung resection.

The main question, which is also addressed by the authors is: is radical lymph node dissection responsible for the worsened outcomes or major surgery itself? Did the authors notice any differences between patients who underwent VATS lobectomy compared to those who underwent open procedure? Were the two groups similar in terms of coexistent diseases preoperatively?

According to Allen et al. there is no difference for mortality and morbidity between patients with early stage lung cancer who underwent mediastinal lymph node dissection or sampling only [2]. Probably smaller lung resections (video-assisted limited wedge resection vs. lobectomy with thoracotomy) could be adequate oncologic procedures in octogenarians with limited life expectancy but resectable disease.

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1. Chida M, Minowa M, Karube Y, Eba S, Okada Y, Miyoshi S, Kondo T. Worsened long-term outcomes and postoperative complications in octogenarians with lung cancer following mediastinal lymph-node dissection. Interact CardioVasc Thorac Surg 2008;8:89–92.[CrossRef][Medline]
2. Allen MS, Darling GE, Pechet TT, Mitchell JD, Herndon JE 2nd, Landre-neau RJ, Inculet RI, Jones DR, Meyers BF, Harpole DH, Putnam JB Jr, Rusch VW. Morbidity and mortality of major pulmonary resections in patients with early-stage lung cancer: initial results of the randomized, prospective ACOSOG Z0030 trial. Ann Thorac Surg 2006;81:1013–1020.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Nikolaos Barbetakis Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Barbetakis, N. Articles by Tsilikas, C. Search for Related Content PubMed PubMed Citation Articles by Barbetakis, N. Articles by Tsilikas, C. Related Collections Related Article