Post-operative outcomes and quality of life assessment after thoracoscopic lobectomy for Non-small-cell lung cancer in octogenarians: Analysis from a national database

Surg Oncol. 2021 Jun:37:101530. doi: 10.1016/j.suronc.2021.101530. Epub 2021 Feb 1.

Abstract

Background: Thoracoscopic lobectomy (VATS-L) for non-small-cell lung cancer (NSCLC) is a well-established option for early stage NSCLC, but the evidences are limited for octogenarians.

Objective: The objectives of this multi-institutional study were to evaluate the post-operative outcomes of VATS-L in octogenarians and to estimate the post-operative quality of life (QoL) using a validated questionnaire (EuroQoL5D).

Methods: Data from patients underwent VATS-L between 2014 and 2019 were analysed and divided into two groups: Group A (younger patients) and Group B (octogenarians). To define predictors for complications, univariate and multivariable logistic regression analysis were performed.

Results: 7023 patients underwent VATS-L and 329 (4.6%) were octogenarians. 30-day and 90-day post-operative mortality were similar (0.95% vs 0.91%, p = 0.84 and 1.3% vs 1.2%, p = 0.58), whereas the percentage of patients who suffered from any complication (25.5% vs 31.9%, p = 0.012) and the complication rate (31.6% vs 45.2%, p=<0.01) were higher for octogenarians. At discharge, the values of EuroQoL5D were worse in group B, but after one month these levels became similar. Age >80 years had a significant influence on morbidity on both univariate and multivariable analyses (p = 0.025).

Conclusions: VATS-L for NSCLC can be performed in selected octogenarians without increased risk of post-operative death, acceptable not-life-threatening complications and a moderate impact on QoL.

Keywords: Complications; Non-small cell lung cancer; Octogenarians; Quality of life; VATS-Lobectomy.

Publication types

  • Comparative Study

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / psychology*
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Databases, Factual
  • Female
  • Humans
  • Italy / epidemiology
  • Lung Neoplasms / pathology
  • Lung Neoplasms / psychology*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Period
  • Quality of Life*
  • Thoracoscopy
  • Treatment Outcome