A prognostic analysis of lung cancer surgery in super-elderly patients: a multicenter real-world data study

PURPOSE: With an increasing life expectancy, pulmonary resection is increasingly performed in super-elderly patients with lung cancer; however, the prognostic factors remain unclear. This study evaluated the postoperative survival and prognostic factors in patients aged ≥ 85 years. METHODS: This multicenter retrospective study included 209 patients aged ≥ 85 years who underwent pulmonary resection with curative intent between 2006 and 2015. Clinical variables, including the pulmonary function, comorbidity, nutritional status, and sarcopenia, were analyzed. Survival was evaluated using the Kaplan-Meier and Cox proportional hazards models. RESULTS: The median age was 86 years, and 119 patients (57.0%) were male. The main surgical procedures were lobectomy in 124 patients, segmentectomy in 37, and wedge resection in 47 patients. The 3-year overall survival (OS) rate was 63.6%, and the median OS was 46.5 months. A multivariate analysis identified male sex and reduced vital capacity as independent predictors of a poor survival. In clinical stage I patients, wedge resection was associated with a poorer survival than anatomical resection, although the baseline characteristics differed between the groups. CONCLUSIONS: Pulmonary resection may be feasible in carefully selected super-elderly patients. A male sex and reduced vital capacity were associated with poorer outcomes, whereas chronological age was not significantly associated with OS in this cohort.