Quality of life in octogenarians with non small cell lung cancer: the strategic role of video assisted thoracic surgery
BMC Geriatrics volume 11, Article number: A65 (2011)
The aim of the present study was to assess the surgical approach in octogenarians comparing the benefits of video-assisted thoracic surgery (VATS) with the open thoracotomy and analysing early and long term quality of life (QOL) changes.
Materials and methods
We reviewed 42 consecutive octogenarians (mean age 82.3±1.4 years) with a preoperative FEV1 of 1.5 L or less who had undergone pulmonary resection for stage I non-small cell lung cancer (NSCLC). Patients were divided into two groups according to surgical approach (VATS group n=22; thoracotomy group n=20) and their postoperative complications and prognoses were evaluated. Quality of life was assessed using Medical Outcome Study Short-Form 36-item Health Survey (SF-36) just before surgery and at 6 and 12 months postoperatively.
Morbidity rate and postoperative hospital stay were significantly different between VATS and thoracotomy group (p=0.01; p=0.0003, respectively). A worse decrease in thoracotomy vs VATS group was demonstrated in five domains at 6 months, and in all domains at 12 months of SF-36 questionnaire. The thoracotomy group presented a significant reduction in the dyspnoea index, FEV1 and DLCO at both 6 and 12 months.
In octogenarians with NSCLC and compromised pulmonary function the long-term survival justifies the operative treatment, and minimally invasive surgical approach enables surgeons to extend pulmonary resection in these high-risk patients if selected appropriately.
Yancik R, Ries LA: Aging and cancer in America. Demographic and epidemiologic perspectives. Hematol Oncol Clin North Am. 2000, 14: 17-23. 10.1016/S0889-8588(05)70275-6.
Jaklitsch MT, Pappas-Estocin A, Bueno R: Thoracoscopic sugery in elderly lung cancer patients. Crit Rev Oncol Hemat. 2004, 49: 165-171. 10.1016/j.critrevonc.2003.08.003.
Walker WS: Video-assisted thoracic surgery (VATS) lobectomy: The Edinnburgh experience. Semin Thorac Cardiovasc Surg. 1998, 10: 291-299.
Nakajiama J, Takamoto S, Kohno T, et al: Costs of videothoracoscopicsurgery vs open resection for patients with lung carcinoma. Cancer. 2000, 89: 2497-2501. 10.1002/1097-0142(20001201)89:11+<2497::AID-CNCR31>3.0.CO;2-5.
Gardner RM, Crapo RO: New recommendations for standardizing spirometry. Chest. 1988, 93: 226-7. 10.1378/chest.93.2.226.
Mountain CF: Revisions in the international system for staging lung cancer. Chest. 1997, 111: 1710-1717. 10.1378/chest.111.6.1710.
Apolone G, Mosconi P: The Italian SF-36 Health Survey: translation, validation and norming. J Clin Epidemiol. 1998, 51: 1025-1036. 10.1016/S0895-4356(98)00094-8.
Hayes V, Morris J, Wolfe C, Morgan M: The SF-36 health survey questionnaire: is it suitable for use with older adults?. Age Aging. 1995, 24 (2): 120-5. 10.1093/ageing/24.2.120.
Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958, 53: 457-481. 10.2307/2281868.
Hoekstra HJ: Cancer study in the elderly. Eur J Cancer. 2001, 37S: 235S-244S.
Aoki T, Tsuchida M, Watanabe T, Hashimoto T, Koike T, Hirono T, Hayashi JI: Surgical strategy for clinical stage I non-small cell lung cancer in octogenarians. Eur J Cardiothorac Surg. 2003, 23: 446-450. 10.1016/S1010-7940(03)00014-9.
Landreneau RJ, Hazelrigg SR, Mack MJ, et al: Postoperative pain-related morbidity: video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg. 1993, 56: 1285-1289. 10.1016/0003-4975(93)90667-7.
Dales RE, Belanger R, Shamji FM, et al: Quality of life following thoracotomy for lung cancer. J Clin Epidemiol. 1994, 47: 1443-1449. 10.1016/0895-4356(94)90088-4.
Zieren HU, Muller JM, Hamberger U, et al: Quality of life after surgical therapy of bronchogenic carcinoma. Eur J Cardiothorac Surg. 1996, 10: 233-237. 10.1016/S1010-7940(96)80144-8.
Sugiura H, Morikawa T, Kaji M, et al: Long term benefits for the quality of life after video-assisted thoracoscopic lobectomy in patients with lung cancer. Surg Lapatosc Endosc Percutan Tech. 1999, 9: 403-408.
Walters SJ, Munro JF, Brzier JE: Using the SF-36 with older adults: a cross-sectional community-based survey. Age Aging. 2001, 30: 337-343. 10.1093/ageing/30.4.337.
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Cite this article
Vicidomini, N.D., Guggino, G. & Monaco, G. Quality of life in octogenarians with non small cell lung cancer: the strategic role of video assisted thoracic surgery. BMC Geriatr 11 (Suppl 1), A65 (2011). https://doi.org/10.1186/1471-2318-11-S1-A65
- Cell Lung Cancer
- Small Cell Lung Cancer
- Postoperative Hospital Stay
- Pulmonary Resection
- Open Thoracotomy