Research Article

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

Table 3

Lung resection in octogenarians: comparative data.

AuthorYears of enrollmentApproach (T, V, R)Resection(s) included
(W, S, L, B, P)
AgeClinical stages includedPathologic stageComplication rate (% overall), severePredictors of increased complications ( values)30-day perioperative mortaiity (%)5-year survival
Predictors of poor survival ( value)

Port et al. [9]1998–2009121V = 40
T = 81
L≥80
(median 82)
I 65.3%
II 25.0%
III 10.0%
53.7%, 28.9% severe requiring significant interventionThoracotomy (63%) versus VATS (35%) = 0.0041.7%56.6%
By stage:
I = 69.6%
II = 35.6%
III = 18.2%
Pathologic stage Ib or greater ( = 0.050)

Hanagiri et al. [18]
1992–199518TS, L, W≥80 (mean, 82.1)IA 6
IB 6
IIB 1
IIIA 5
IA 4
IB 5
IIB 4
IIIA 1
IIIB 4
50%0%

Aoki et al. [7]1981–199835W or S 10
L 25
≥80
(mean 81.2)
IA 14
IB 10
IIA 0
IIB 5
IIIA 5
IIIB 1
60%0%39.8%

Pagni et al. [8]1980–199554TW 3
S 3
L 43
B 2
P 1
chest wall 1
sleeve 1 
≥80
I
II
IIIA
42%, 11%3.7%43%>stage I ( value not given)

Clavien et al. [19]2000–2009191V 77%
T 
W 77
S 13
L 96
P 3
≥80
(median 82)
I 56%
II 10%
III 9%
IV 3%
46%Resection greater than wedge
( = 0.0064), thoracotomy as approach ( = 0.034), % predicted FEV1 for ea 10% decrement ( = 0.01)
3.6%3-year stage I (109 patients) 56%

Umezu et al. [10]  
2001–200844≥80 (mean 82)65.9%2.3%54.5%

Okada et al. [17]  
44≥80 (mean 81.8)20%044.9%

Okami et al. [11]1999367W 80
S 42
L 245 
80–90 (mean 82)II 300
II 44
III 23
8.4%Comorbidity and mediastinal lymph node dissection1.4%56.1%Advanced pathologic stage and comorbidity

Chida et al. [16]1981–200648S 3
L 45
P 2
≥80 (mean 81.7)I 36
II 3
III 9
I 30
II 8
III 10
68.8%Mediastinal LN dissection ( = 0.004)35%Med LN dissection ( = 0.022)

Suemitsu et al. [15]1981–2006146W 38 (26%)
S 17 (11.6%)
L 79 (54.1%)
B 7 (4.8%)
P 1 (0.7%)
Explorations 4 (2.7%)
≥80 (mean 82.6)I 109 (74.7%)
II 14 (9.6%)
III 22 (15.1%)
IV 1 (0.7%)
I 94 (64.3%)
II 16 (11.0%)
III 31 (21.2%)
IV 5 (3.5%)
46.8%

Mun and Kohno [14]1999–200655VW 10 (18.2%)
S 7 (12.7%)
L 37 (67.3%)
B 1 (1.8%) 
80–89 (mean 82.7)IA 32
IB 23
I 44
II 6
III 5
25.6%3.6%65.9%

Ikeda et al. [13]1981–200273V and TL 45 (62%)
B 2 (2.7%)
S 6 (8.2%)
W 20 (27%) 
80–89 (mean 83)I 60
II 10
IIIA 3
I 55 (74.3%)
II 8 (11%)
IIIA 5 (6.8%)
IIIB 4 (5.5%)
IV 1 (1.4%)
37%4.1%47%Pathologic stage III compared to II ( = 0.02)

Matsuoka et al. [12]1997–20044085% Muscle sparing PLT/VATS, 15%
standard PLT
W 30%
S 30%
L 40% 
80–89IA 52.5%
iB 35.5%
IIA 0
IIB 7.5%
IIIA 5%
20%0%56.9%

Current Study2004–201245T 59%
V 26%
R 26%
L≥80 (mean 82)
IA 51%
IB 21%
IIA 11%
IIB 2.2%
IIIA 11% 
IA 26%
IB 33%
IIA 8%
IIB 8%
IIIA 18%
IIIB 3%
IV 5%
62%, 17%2%52%