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Canadian Respiratory Journal
Volume 2017 (2017), Article ID 6294895, 9 pages
https://doi.org/10.1155/2017/6294895
Research Article

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

1Division of Thoracic and Foregut Surgery, Swedish Medical Center and Cancer Institute, 1101 Madison Street, Suite 900, Seattle, WA 98104, USA
2Surgical Specialists of Charlotte, 2001 Vail Ave., Suite 320, Charlotte, NC 28207, USA
3Department of Surgery, Chest Disease Center, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Suite 201, Boston, MA 02215, USA

Correspondence should be addressed to Andrew Feczko; gro.hsidews@okzcef.werdna

Received 15 November 2016; Revised 9 January 2017; Accepted 11 January 2017; Published 8 February 2017

Academic Editor: Hisao Imai

Copyright © 2017 Andrew Feczko et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.