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Competing Risk Analysis in Lung Cancer Patients Over 80 Years Old Undergoing Surgery

  • Haruaki Hino
  • Takahiro Karasaki
  • Yukihiro Yoshida
  • Takeshi Fukami
  • Atsushi Sano
  • Makoto Tanaka
  • Yoshiaki Furuhata
  • Kosuke Kashiwabara
  • Junji Ichinose
  • Mitsuaki Kawashima
  • Jun NakajimaEmail author
Original Scientific Report
  • 43 Downloads

Abstract

Background

This study aimed to analyze cause-specific mortality in lung cancer patients over 80 years old undergoing surgery.

Methods

This retrospective, multi-institutional analysis included patients aged ≥ 80 years who underwent radical surgery for primary lung cancer from January 1998 to December 2015. Preoperative clinical data, surgical results, survival, and cause of death were evaluated. Competing risk analysis for cause-specific mortality was performed.

Results

Of the 337 patients (median age 82 years) enrolled and analyzed, 68.1% were male. There were 52 and 44 cancer-specific and non-cancer-specific deaths, respectively. On competing risk regression analysis, non-cancer-specific deaths were significantly associated with male sex (hazard ratio [HR]: 3.06, 95% confidence interval [CI]: 1.02–9.12, p = 0.046), coronary artery disease (HR: 2.49, 95% CI: 2.49 [1.14–5.47], p = 0.02), interstitial pneumonia (HR: 3.58, 95% CI: 1.73–7.40, p < 0.001), and pathological stage III (HR: 3.83, 95% CI: 1.44–10.13, p = 0.007). In contrast, cancer-specific deaths were significantly associated with limited resection (HR: 1.99, 95% CI: 1.02–3.89, p = 0.04) and pathological stage III (HR: 3.13, 95% CI: 1.44–6.80, p = 0.004). The 5-year cumulative incidences of lung cancer-specific and non-cancer-specific deaths were 18.0% and 15.9%, respectively.

Conclusions

Prognostic factors for non-cancer-specific death were different from those of cancer-specific death, except for pathological stage. Each prognostic factor should be considered when deciding surgical indication and procedure and monitoring for pulmonary events during outpatient follow-up.

Notes

Acknowledgements

We are deeply grateful to Editage for English proofreading.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

268_2019_4982_MOESM1_ESM.pdf (33 kb)
Cumulative incidence of death curve stratified by lung cancer-specific and non-cancer-specific deaths within 30 months after surgery (PDF 33 kb)

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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Haruaki Hino
    • 1
  • Takahiro Karasaki
    • 2
  • Yukihiro Yoshida
    • 3
  • Takeshi Fukami
    • 4
  • Atsushi Sano
    • 5
  • Makoto Tanaka
    • 6
  • Yoshiaki Furuhata
    • 7
  • Kosuke Kashiwabara
    • 8
  • Junji Ichinose
    • 2
  • Mitsuaki Kawashima
    • 2
  • Jun Nakajima
    • 2
    Email author
  1. 1.Department of Thoracic SurgeryTokyo Metropolitan Geriatric Hospital and Institute of GerontologyTokyoJapan
  2. 2.Department of Thoracic SurgeryThe University of Tokyo Graduate School of MedicineTokyoJapan
  3. 3.Department of Thoracic SurgeryAsahi General HospitalChibaJapan
  4. 4.Department of Thoracic SurgeryNational Hospital Organization Tokyo National HospitalTokyoJapan
  5. 5.Department of Thoracic SurgeryChigasaki Municipal HospitalKanagawaJapan
  6. 6.Department of Thoracic SurgeryJR Tokyo General HospitalTokyoJapan
  7. 7.Department of Thoracic SurgeryJapanese Red Cross Medical CenterTokyoJapan
  8. 8.Department of Biostatistics, School of Public HealthThe University of TokyoTokyoJapan

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