OBJECTIVES Surgeons will face an increasing number of octogenarians with lung cancer potentially curable by surgery. The goal of this study was to evaluate short- and long-term outcomes after lung resection. METHODS We performed a single-centre study of consecutive patients ≥80 years old, surgically treated for suspected lung cancer between 2009 and 2016. Age, sex, performance status, lung function, surgical approach, type of lung resection, complications, in-hospital and 30- and 90-day deaths and long-term survival were analysed. RESULTS Two hundred and fifty-seven patients were enrolled. The median age was 82 years (range 80-97). One hundred and thirty-four patients were treated by thoracotomy and 123 by video-assisted thoracic surgery [10 (8.1%) converted]. Two hundred and thirty-two underwent lobar resection and 25 underwent sublobar resection. There were no intraoperative deaths and 9 admissions to the intensive therapy unit; 112 (43.6%) patients suffered complications: More complications occurred after lobar versus after sublobar resections [45.7% vs 24% (P = 0.037)] and in those with chronic obstructive pulmonary disease (COPD) [57.4% vs 40% (P = 0.02)]. The 30-day mortality was 3.9% (n = 10) and the 90-day mortality was 6.22% (n = 16). One hundred and sixty-seven patients died during the study period; patients with non-small-cell lung cancer (n = 233) had a median survival of 46.5 months with 67.2% alive at 2 years and 40.8% at 5 years. Pathological stage and R status were independent prognostic factors for survival. CONCLUSIONS Surgery for malignancies in octogenarians is feasible and safe with good long-term outcomes. The risk of postoperative complications, especially in those with COPD, is high but can be minimized with sublobar resection. Postoperative mortality is acceptable, and long-term survival is primarily governed by lung cancer stage. Age is no reason to deny patients surgery for early-stage disease.

中文翻译：

---

八十多岁肺癌手术治疗的风险和回报。

目标外科医生将面临越来越多的八十多岁的肺癌患者，这些肺癌可能通过手术治愈。本研究的目的是评估肺切除术后的短期和长期结果。方法 我们对 2009 年至 2016 年间因疑似肺癌接受手术治疗的≥80 岁连续患者进行了单中心研究。年龄、性别、体能状态、肺功能、手术方法、肺切除类型、并发症、住院并分析了 30 天和 90 天的死亡和长期存活率。结果 257 名患者入组。中位年龄为 82 岁（范围 80-97）。134 名患者接受了开胸手术治疗，123 名患者接受了电视胸腔镜手术治疗 [10 (8.1%) 转化]。232 人接受了肺叶切除术，25 人接受了亚肺叶切除术。没有术中死亡，9 人进入重症监护室；112 (43.6%) 名患者出现并发症：肺叶切除术后并发症发生率高于亚肺叶切除术后 [45.7% vs 24% (P = 0.037)] 和慢性阻塞性肺疾病 (COPD) [57.4% vs 40% (P = 0.02)]。30 天死亡率为 3.9%（n = 10），90 天死亡率为 6.22%（n = 16）。研究期间有 167 名患者死亡；非小细胞肺癌患者 (n = 233) 的中位生存期为 46.5 个月，其中 67.2% 在 2 年时存活，在 5 年时存活率为 40.8%。病理分期和 R 状态是生存的独立预后因素。结论 八十多岁的恶性肿瘤手术是可行和安全的，具有良好的长期结果。术后并发症的风险，尤其是在 COPD 患者中，风险很高，但可以通过亚肺叶切除术将其降至最低。术后死亡率是可以接受的，长期生存主要取决于肺癌分期。年龄不是拒绝患者早期疾病手术的理由。