Surgical Treatment for Non-Small Cell Lung Cancer in Elderly Patients

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  • Ogawa Fumihiro
    Department of Thoracic Surgery, Kitasato University School of Medicine
  • Satoh Yukitoshi
    Department of Thoracic Surgery, Kitasato University School of Medicine

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  • 高齢者に対する外科的治療～呼吸器 (肺癌)
  • コウレイシャ ニ タイスル ゲカテキ チリョウ : コキュウキ(ハイガン)

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Abstract

It is known that non-small cell lung cancer (NSCLC) morbidity rises linearly with age. Moreover, since elderly populations are on the increase, it is expected that surgical treatment for such patients will also be more common in the future. Therefore, a rationale for safe and effective surgery is very important to improve surgical outcome.<br>Careful perioperative care is required to avoid preoperative comorbidity including cardiorespiratory dysfunction in elderly patients, and it is desirable that operations be limited. For example, segmental resection should be considered only for preservation of postoperative respiratory function for lower than performance status (PS) 2, clinical stage I cases.<br>The recent employment of video-assisted thoracic surgery (VATS) for early-stage NSCLC patients means that safe and satisfactory results can be achieved with less physical stress. We here describe the significance and utility of surgical treatment for NSCLCs in elderly patients considering the progressive aging of societies. In particular, surgical treatment can be recommended as a standard treatment for elderly patients when there is a good PS and relatively minor complicating frailty or disease. Thus, we should choose a treatment strategy suitable for each case taking into account quality of life (QOL) decrease due to preoperative comorbidity, organ functional decline with aging, and complications of surgery.

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