Decrease in performance status after lobectomy mean poor prognosis in elderly lung cancer patients
Surgery remains the best treatment for obtaining cure in patients with resectable lung cancer, regardless of age. In elderly patients, however, the presumed fear of decreased performance status (PS) after lobectomy has resulted in the delivery of sub-optimal cancer surgery. Surgical decision making...
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| Veröffentlicht in: | Journal of thoracic disease 2017-06, Vol.9 (6), p.1525-1530 |
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| container_title | Journal of thoracic disease |
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| creator | Kawaguchi, Yo Hanaoka, Jun Oshio, Yasuhiko Hashimoto, Masayuki Igarashi, Tomoyuki Kataoka, Yoko Kaku, Ryosuke Namura, Yuki Akazawa, Akira |
| description | Surgery remains the best treatment for obtaining cure in patients with resectable lung cancer, regardless of age. In elderly patients, however, the presumed fear of decreased performance status (PS) after lobectomy has resulted in the delivery of sub-optimal cancer surgery. Surgical decision making for such patients would become easier if post-lobectomy survival benefits and changes in PS were well defined.
We reviewed patients aged 75 years or older who received lobectomy for non-small cell lung cancer (NSCLC) at our hospital between January 2004 and December 2014. Eastern Cooperative Oncology Group PS was preoperatively and postoperatively assessed in 137 patients. Patients were classified into 2 groups based on the change in PS: in Group 1, postoperative and preoperative PS were the same; in group 2, postoperative PS was less than preoperative PS. We compared the characteristics of patients in groups 1 and 2.
Overall 5-year survival was 47.4% in group 1 and 0% in group 2 (P |
| doi_str_mv | 10.21037/jtd.2017.04.37 |
| format | Article |
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We reviewed patients aged 75 years or older who received lobectomy for non-small cell lung cancer (NSCLC) at our hospital between January 2004 and December 2014. Eastern Cooperative Oncology Group PS was preoperatively and postoperatively assessed in 137 patients. Patients were classified into 2 groups based on the change in PS: in Group 1, postoperative and preoperative PS were the same; in group 2, postoperative PS was less than preoperative PS. We compared the characteristics of patients in groups 1 and 2.
Overall 5-year survival was 47.4% in group 1 and 0% in group 2 (P<0.001). History of cardiac ischemia (P=0.001) and squamous cell carcinoma (P=0.015) were identified as significant predictors of reduced postoperative PS.
Our results show that maintenance of PS after lobectomy is expected to be associated with a good prognosis. However, reduction of PS after lobectomy indicates an extremely poor prognosis in elderly patients with lung cancer. History of cardiac ischemia and squamous cell carcinoma are possible risk factors for decreasing PS. Thus, careful patient evaluation and selection are needed when deciding whether to use lobectomy in clinical practice.</description><identifier>ISSN: 2072-1439</identifier><identifier>EISSN: 2077-6624</identifier><identifier>DOI: 10.21037/jtd.2017.04.37</identifier><identifier>PMID: 28740665</identifier><language>eng</language><publisher>China: AME Publishing Company</publisher><subject>Original</subject><ispartof>Journal of thoracic disease, 2017-06, Vol.9 (6), p.1525-1530</ispartof><rights>2017 Journal of Thoracic Disease. All rights reserved. 2017 Journal of Thoracic Disease.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-9c6838a455e2ca23326d1b73324d04d303a8af42dff7b732ad9ad70edd8856733</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506121/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506121/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28740665$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kawaguchi, Yo</creatorcontrib><creatorcontrib>Hanaoka, Jun</creatorcontrib><creatorcontrib>Oshio, Yasuhiko</creatorcontrib><creatorcontrib>Hashimoto, Masayuki</creatorcontrib><creatorcontrib>Igarashi, Tomoyuki</creatorcontrib><creatorcontrib>Kataoka, Yoko</creatorcontrib><creatorcontrib>Kaku, Ryosuke</creatorcontrib><creatorcontrib>Namura, Yuki</creatorcontrib><creatorcontrib>Akazawa, Akira</creatorcontrib><title>Decrease in performance status after lobectomy mean poor prognosis in elderly lung cancer patients</title><title>Journal of thoracic disease</title><addtitle>J Thorac Dis</addtitle><description>Surgery remains the best treatment for obtaining cure in patients with resectable lung cancer, regardless of age. In elderly patients, however, the presumed fear of decreased performance status (PS) after lobectomy has resulted in the delivery of sub-optimal cancer surgery. Surgical decision making for such patients would become easier if post-lobectomy survival benefits and changes in PS were well defined.
We reviewed patients aged 75 years or older who received lobectomy for non-small cell lung cancer (NSCLC) at our hospital between January 2004 and December 2014. Eastern Cooperative Oncology Group PS was preoperatively and postoperatively assessed in 137 patients. Patients were classified into 2 groups based on the change in PS: in Group 1, postoperative and preoperative PS were the same; in group 2, postoperative PS was less than preoperative PS. We compared the characteristics of patients in groups 1 and 2.
Overall 5-year survival was 47.4% in group 1 and 0% in group 2 (P<0.001). History of cardiac ischemia (P=0.001) and squamous cell carcinoma (P=0.015) were identified as significant predictors of reduced postoperative PS.
Our results show that maintenance of PS after lobectomy is expected to be associated with a good prognosis. However, reduction of PS after lobectomy indicates an extremely poor prognosis in elderly patients with lung cancer. History of cardiac ischemia and squamous cell carcinoma are possible risk factors for decreasing PS. Thus, careful patient evaluation and selection are needed when deciding whether to use lobectomy in clinical practice.</description><subject>Original</subject><issn>2072-1439</issn><issn>2077-6624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNpVkc1rGzEQxUVoiUPqc29Fx1zW0ddKu5dCcPNRMPTSnsVYmnU37K5cSVvwf185Tkyjy4jRb94b9Aj5zNlKcCbN7XP2K8G4WTG1kuaCXAlmTKW1UB9e7qLiSrYLskzpmZWjmRDGXJKFaIxiWtdXZPsNXURISPuJ7jF2IY4wOaQpQ54ThS5jpEPYosthPNARoXAhRLqPYTeF1KfjJA4e43CgwzztqDsKFAByj1NOn8jHDoaEy9d6TX493P9cP1WbH4_f13ebyslW5qp1upENqLpG4UBIKbTnW1Oq8kx5ySQ00Cnhu86UtgDfgjcMvW-aWhfumnw96e7n7YjeFe8Ig93HfoR4sAF6-_5l6n_bXfhr65ppLngRuHkViOHPjCnbsU8OhwEmDHOyvBWSc1k-rqC3J9TFkFLE7mzDmX0Jx5Zw7DEcy5SVpkx8-X-7M_8WhfwHwzSNMw</recordid><startdate>201706</startdate><enddate>201706</enddate><creator>Kawaguchi, Yo</creator><creator>Hanaoka, Jun</creator><creator>Oshio, Yasuhiko</creator><creator>Hashimoto, Masayuki</creator><creator>Igarashi, Tomoyuki</creator><creator>Kataoka, Yoko</creator><creator>Kaku, Ryosuke</creator><creator>Namura, Yuki</creator><creator>Akazawa, Akira</creator><general>AME Publishing Company</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201706</creationdate><title>Decrease in performance status after lobectomy mean poor prognosis in elderly lung cancer patients</title><author>Kawaguchi, Yo ; Hanaoka, Jun ; Oshio, Yasuhiko ; Hashimoto, Masayuki ; Igarashi, Tomoyuki ; Kataoka, Yoko ; Kaku, Ryosuke ; Namura, Yuki ; Akazawa, Akira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-9c6838a455e2ca23326d1b73324d04d303a8af42dff7b732ad9ad70edd8856733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Original</topic><toplevel>online_resources</toplevel><creatorcontrib>Kawaguchi, Yo</creatorcontrib><creatorcontrib>Hanaoka, Jun</creatorcontrib><creatorcontrib>Oshio, Yasuhiko</creatorcontrib><creatorcontrib>Hashimoto, Masayuki</creatorcontrib><creatorcontrib>Igarashi, Tomoyuki</creatorcontrib><creatorcontrib>Kataoka, Yoko</creatorcontrib><creatorcontrib>Kaku, Ryosuke</creatorcontrib><creatorcontrib>Namura, Yuki</creatorcontrib><creatorcontrib>Akazawa, Akira</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of thoracic disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawaguchi, Yo</au><au>Hanaoka, Jun</au><au>Oshio, Yasuhiko</au><au>Hashimoto, Masayuki</au><au>Igarashi, Tomoyuki</au><au>Kataoka, Yoko</au><au>Kaku, Ryosuke</au><au>Namura, Yuki</au><au>Akazawa, Akira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Decrease in performance status after lobectomy mean poor prognosis in elderly lung cancer patients</atitle><jtitle>Journal of thoracic disease</jtitle><addtitle>J Thorac Dis</addtitle><date>2017-06</date><risdate>2017</risdate><volume>9</volume><issue>6</issue><spage>1525</spage><epage>1530</epage><pages>1525-1530</pages><issn>2072-1439</issn><eissn>2077-6624</eissn><abstract>Surgery remains the best treatment for obtaining cure in patients with resectable lung cancer, regardless of age. In elderly patients, however, the presumed fear of decreased performance status (PS) after lobectomy has resulted in the delivery of sub-optimal cancer surgery. Surgical decision making for such patients would become easier if post-lobectomy survival benefits and changes in PS were well defined.
We reviewed patients aged 75 years or older who received lobectomy for non-small cell lung cancer (NSCLC) at our hospital between January 2004 and December 2014. Eastern Cooperative Oncology Group PS was preoperatively and postoperatively assessed in 137 patients. Patients were classified into 2 groups based on the change in PS: in Group 1, postoperative and preoperative PS were the same; in group 2, postoperative PS was less than preoperative PS. We compared the characteristics of patients in groups 1 and 2.
Overall 5-year survival was 47.4% in group 1 and 0% in group 2 (P<0.001). History of cardiac ischemia (P=0.001) and squamous cell carcinoma (P=0.015) were identified as significant predictors of reduced postoperative PS.
Our results show that maintenance of PS after lobectomy is expected to be associated with a good prognosis. However, reduction of PS after lobectomy indicates an extremely poor prognosis in elderly patients with lung cancer. History of cardiac ischemia and squamous cell carcinoma are possible risk factors for decreasing PS. Thus, careful patient evaluation and selection are needed when deciding whether to use lobectomy in clinical practice.</abstract><cop>China</cop><pub>AME Publishing Company</pub><pmid>28740665</pmid><doi>10.21037/jtd.2017.04.37</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| title | Decrease in performance status after lobectomy mean poor prognosis in elderly lung cancer patients |
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