Clinical and functional outcomes after curative resection in octogenarians with clinical stage I non-small cell lung cancer

Abstract

Studies have reported that most non-small cell lung cancer (NSCLC) patients were diagnosed around the age of 70 and that only 10% of cases were diagnosed in octogenarians. The incidence of lung cancer in older adults will increase due to the aging of the global population. Recent studies have shown surgical treatment to have benefits over non-surgical treatment in octogenarian early stage NSCLC patients [ [1] , [2] ]. However, the fear of postoperative complications can make surgeons reluctant to perform surgical treatment. Recently, video-assisted thoracic surgery (VATS) has been widely performed to treat early-stage NSCLC, leading to a decreased incidence of postoperative complications [ [3] ]. In addition, the average life expectancy and quality of life after surgery should be taken into consideration. Decisions regarding the treatment strategy must carefully balance the risks of postoperative morbidity and mortality with the risks related to cancer recurrence and long-term survival. Lobectomy is still the current standard treatment for early-stage NSCLC in the general population. However, sublobar resection, such as wedge resection or segmentectomy, can be indicated in patients who may not tolerate a lobar lung resection or who had small sized NSCLC. The most suitable extent of surgical resection remains unclear due to the limited available data in this age group. Additionally, very few studies have investigated changes in pulmonary function after surgical resection