Lobectomy and pneumonectomy in patients over 70 years of age for the treatment of lung cancer: evaluation of surgical outcomes

Abstract

Aims: The primary aim of this study is to evaluate the surgical outcomes of lobectomy and pneumonectomy operations performed due to lung cancer in individuals aged 70 and above, and to analyze the factors influencing these outcomes. Methods: This retrospective study covers lobectomy and pneumonectomy operations performed on 103 lung cancer patients over the age of 70, from January 2018 to December 2021. A dataset was created including patients’ demographic information, smoking status, comorbidities, results of pulmonary function tests and echocardiography, preoperative complete blood count, and serum albumin levels, and these data were analyzed. Results: The average age of the patients was 73.3; 83.5% were male, and 16.5% were female. The complication rate was 47.6%, and the 30-day surgical mortality rate was 8.7%. Patients with a high American Society of Anesthesiologists (ASA) score had higher rates of complications and mortality (p=0.015). Low preoperative serum albumin (p=0.017) and hemoglobin (p=0.026) levels were associated with an increased risk of complications. Postoperative outcomes between Video Assisted Thoracoscopic Surgery (VATS) and thoracotomy were found to be similar. Conclusion: The study demonstrates that in elderly lung cancer surgery, comorbidities and preoperative nutritional status are decisive factors affecting surgical outcomes. Preoperative albumin and hemoglobin levels emerge as significant indicators in assessing the risk of postoperative complications. VATS and thoracotomy are surgical techniques with similar safety and efficacy profiles.