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Older age is not a negative factor for video-assisted thoracoscopic lobectomy for pathological stage I non-small cell lung cancer: a single-center, retrospective, propensity score-matching study

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Abstract

Purpose

Video-assisted thoracoscopic surgery (VATS) has changed the surgical approach to non-small cell lung cancer (NSCLC) dramatically. The current study compares the outcomes of older and younger patients who underwent VATS lobectomy for NSCLC.

Methods

In total, 424 eligible patients with pathological stage I NSCLC underwent VATS lobectomy between 2007 and 2017. Patients were classified into two groups (< 75 and ≥ 75 years old), after which propensity score-matching was performed.

Results

After matching, 143 patients were identified. No significant difference in postoperative complication rates was observed; however, the ≥ 75-year-old group had a longer postoperative hospital stay (p = 0.001). The 5-year overall survival, relapse-free survival, and lung cancer-specific survival rates of the < 75- and ≥ 75-year-old groups were 87.1% vs. 85.6% (p = 0.537), 82.1% vs. 79.0% (p = 0.531), and 93.5% vs. 92.7% (p = 0.832), respectively.

Conclusion

Despite the longer postoperative recovery following VATS lobectomy, the short- and long-term outcomes of older patients did not differ from those of younger patients. Thus, for early-stage NSCLC, older age alone was not a negative factor for lobectomy performed via minimally invasive surgery. Naturally, the systemic condition of this population must be evaluated carefully before surgery.

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Data Availability

The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study.

Abbreviations

CCI:

Charlson comorbidity index

CI:

Confidence interval

CT:

Computed tomography

CSS:

Cancer-specific survival

DLCO:

Diffusing capacity of the lung carbon monoxide

FEV 1.0:

Forced expiratory volume in 1.0 s

JATS:

Japanese Association for Thoracic Surgery

NSCLC:

Non-small cell lung cancer

OS:

Overall survival

PS:

Performance status

RFS:

Relapse-free survival

TTE:

Transthoracic echocardiography

VATS:

Video-assisted thoracoscopic surgery

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Acknowledgements

We acknowledge the members of the Thoracic Surgery Department at Shimane University Hospital for their assistance with the preparation of this manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Aomori Prefectural Central Hospital, 2-1-1, Higashitsukurimichi, Aomorishi, Aomori, 030-8553, Japan

    Tomohiro Fujita

  2. Department of Thoracic Surgery, Tachikawa General Hospital, 1-24, Asahioka, Nagaokashi, Niigata, 940-8621, Japan

    Akira Koyanagi & Koji Kishimoto

  3. Department of Thoracic Surgery, Shimane University Hospital, 89-1, Enya, Izumoshi, Shimane, 693-8501, Japan

    Tomohiro Fujita, Akira Koyanagi & Koji Kishimoto

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  1. Tomohiro Fujita
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Correspondence to Tomohiro Fujita.

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Fujita, T., Koyanagi, A. & Kishimoto, K. Older age is not a negative factor for video-assisted thoracoscopic lobectomy for pathological stage I non-small cell lung cancer: a single-center, retrospective, propensity score-matching study. Surg Today 53, 824–833 (2023). https://doi.org/10.1007/s00595-022-02628-y

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  • DOI: https://doi.org/10.1007/s00595-022-02628-y

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