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High postoperative risk after pneumonectomy in elderly patients with right-sided lung cancer

¹ University Hospital Rotterdam, Dept of Pulmonology and ² Comprehensive Cancer Centre Rotterdam, Dept of Research, Rotterdam, the Netherlands

CORRESPONDENCE: J.P. van Meerbeeck, University Hospital Rotterdam, Dept of Pulmonology, PO Box 5201, 3008 AE, Rotterdam, the Netherlands. Fax: 31 104634856

Keywords: elderly, lung cancer, mortality, pneumonectomy, surgery

Received: March 15, 2001
Accepted September 13, 2001

The present study investigated postoperative mortality (POM), its predictors and relationship with long-term survival in patients who underwent surgery for lung cancer.

The 30-day mortality after thoracotomy in 1,830 patients from the Flemish multicentre hospital-based lung cancer registry was analysed according to patient, tumour, treatment and hospital characteristics and compared with 5-yr survival figures for the same patients.

Overall POM was 4.4%. In univariate analysis age, extent of surgery and low hospital volume were associated with a higher POM. In multiple regression analysis age, extent of surgery and side of the pneumonectomy proved to be independent predictors of POM. In patients aged >70 yrs who underwent right-sided pneumonectomy POM was 17.8%.

Overall, mortality was comparable to published series from referral centres. Age and extent of resection are the main predictors of postoperative mortality in lung-cancer patients. In the operable elderly patient, age alone does not justify denying the survival benefit experienced by resection of lung cancer. The high mortality after right-sided pneumonectomy in elderly patients warrants caution, as the treatment benefit may become marginal.

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