Studio retrospettivo FONICAP sul follow-up di ottuagenari trattati con exeresi radicale per non-small cell lung carcinoma

Background. Octogenarians present in the last decade more than in the past with potentially resectable bronchogenic carcinoma. The purpose of this FONICAP retrospective study was to analyze the risks associated with pulmonary curative resection for primary non-small cell lung cancer in octogenarians operated at Forlanini Hospital in Rome from 1997 through 2006. Methods. We evaluated short - and long-term results (in particular: complications and survival) observed in the follow-up of 38 octogenarians who underwent curative resection: 25 lobectomies and 13 atipical resections (segmentectomy or wedge resection). ECOG Performance Status: 0 in 36 patients and 1 in 2 patients. Demographics of patients were the following: 27 male and 11 female, median age 82 years (range 80-85), tumor histotype 25 adenocarcinoma and 13 squamous carcinoma, pathological TNM stage 34,2% IA, 21,06%, 31,5% IIB, 5,26% IIIA and 7,89% IIIB. Results. No perioperative and post-operative mortality was observed. Actuarial survival at 3 years and 5 years was 50% and 28,9% respectively. The overall complications rate was 42,16%: all of these were "minor" cardiac and/or pulmonary complications. The average post-operative lenght of stay was 7 days. Conclusions. Based on our findings advanced age is not a negative factor for surgery in properly selected octogenarians: the surgical treatment of non-small cell lung carcinoma can thus be performed in patients without significant increasing either in morbidity or mortality, while also obtaining long-term survival. However the decision as to proceed with the pulmonary resection is multifactorial: one of such factors must be the complete information frankly offered to the patients.