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Copyright ©ERS Journals Ltd 2002
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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