Jia Chunyi, Qiwen Wang, ShaolinSun, Lei Wang

Department of Thoracic Surgery, Jilin Province TumorHospital

Objective:Life expectancy has continuously improvedin recently years with the development of medical level. In 2012, the amount ofpeople who was above 60 years old has reached 810 millionand account for 11% ofworldwide population. The worldwide population shift towards older ages willinevitably lead to more elderly patients being diagnosed with non-small celllung cancer (NSCLC). It still remains controversial whether sublobar resectionis effective in such cases. In order to solve this question, we need tounderstand the clinical characteristics of these tumors. Method: From2006 to 2012, a total of 310 patients with NSCLC who was above 65 years oldunderwent surgical resection in Department of Thoracic Surgery, the FirstAffiliated Hospital of China Medical University and the Second Department ofThoracic Surgical Oncology, Jilin Province Tumor Hospital. The clinical datawere retrospectively analyzed in sex, stage, histology, smoking status, smokingamount, drinking status, surgical approaches, multimodality therapy and overallsurvival. Survival was analyzed by Kaplan–Meier method andlog-rank test. Result:There were 256 (82.6%) elderly patients who underwent standard lobectomiesand 54 (17.4%) patients who underwent sublobar resections. The overall 5-yearsurvival rate was 52.9%. Patients with different surgical approaches (lobectomyand sublobar resection) had nearly the same 5-year survival rates (60.5% vs60.8%, P=0.381). The prognosis were significantly influenced by gender (P=0.024),stage of disease (P=0.028), smoking status (P=0.034) and smokingamount (P=0.028). The multivariate Cox proportional hazards analysisrevealed that the smoking statuswas associated with the hazard ratio of 1.660(1.058-2.606; P=0.028). Conclusion: In elderly NSCLC patients,sublobar resection is considered to be an appropriate treatment in comparisonwith lobectomy, as this procedure provides anequivalent long-term survival. Thesurvival of elderly patients with lung cancer is closely related to the smokingstatus.

Key Words: Nonsmall cell lungcancer  Elderly  Surgical resect