Post-operative outcomes and quality of life assessment after thoracoscopic lobectomy for Non-small-cell lung cancer in octogenarians: Analysis from a national database. (June 2021)

• Record Type: Journal Article
• Authors: Bongiolatti, Stefano; Gonfiotti, Alessandro; Borgianni, Sara; Crisci, Roberto; Curcio, Carlo; Voltolini, Luca; Alloisio, Marco; Amore, Dario; Ampollini, Luca; Andreetti, Claudio; Argnani, Desideria; Baietto, Guido; Bandiera, Alessandro; Benato, Cristiano; Benvenuti, Mauro Roberto; Bertani, Alessandro; Bertolaccini, Luca; Bortolotti, Luigi; Bottoni, Edoardo; Breda, Cristiano; Camplese, Pierpaolo; Carbognani, Paolo; Cardillo, Giuseppe; Casadio, Caterina; Cavallesco, Giorgio; Cherchi, Roberto; Crisci, Roberto; Curcio, Carlo; Dell'Amore, Andrea; Della Beffa, Vittorio; Dolci, Giampiero; Droghetti, Andrea; Ferrari, Paolo A.; Fontana, Diego; Gargiulo, Gaetano; Gasparri, Roberto; Gavezzoli, Diego; Ghisalberti, Marco; Giovanardi, Michele; Gonfiotti, Alessandro; Guerrera, Francesco; Imperatori, Andrea; Infante, Maurizio; Iurilli, Luciano; Lausi, Paolo; Lo Giudice, Fabio; Londero, Francesco; Luzzi, Luca; Lopez, Camillo; Mancuso, Maurizio; Maniscalco, Pio; Margaritora, Stefano; Meacci, Elisa; Melloni, Giulio; Morelli, Angelo; Mucilli, Felice; Natali, Pamela; Negri, Giampiero; Nicotra, Samuele; Nosotti, Mario; Pariscenti, Gianluca; Perkmann, Reinhold; Pernazza, Fausto; Pirondini, Emanuele; Poggi, Camilla; Puma, Francesco; Refai, Majed; Rinaldo, Alessandro; Rizzardi, Giovanna; Rosso, Lorenzo; Rotolo, Nicola; Russo, Emanuele; Sabbatini, Armando; Scarci, Marco; Spaggiari, Lorenzo; Stefani, Alessandro; Solli, Piergiorgio; Surrente, Corrado; Terzi, Alberto; Torre, Massimo; Vinci, Damiano; Viti, Andrea; Voltolini, Luca; Zaccagna, Gino; Zaraca, Francesco;
• Is Part Of: Surgical oncology. Volume 37(2021)
• Publication Date: 2021-06
• Subjects: VATS-Lobectomy -- Non-small cell lung cancer -- Octogenarians -- Complications -- Quality of life; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2021.101530
• Languages: English
• ISSNs: 0960-7404

Abstract

Abstract: Background: Thoracoscopic lobectomy (VATS-L) for non-small-cell lung cancer (NSCLC) is a well-established option for early stage NSCLC, but the evidences are limited for octogenarians. Objective: The objectives of this multi-institutional study were to evaluate the post-operative outcomes of VATS-L in octogenarians and to estimate the post-operative quality of life (QoL) using a validated questionnaire (EuroQoL5D). Methods: Data from patients underwent VATS-L between 2014 and 2019 were analysed and divided into two groups: Group A (younger patients) and Group B (octogenarians). To define predictors for complications, univariate and multivariable logistic regression analysis were performed. Results: 7023 patients underwent VATS-L and 329 (4.6%) were octogenarians. 30-day and 90-day post-operative mortality were similar (0.95% vs 0.91%, p = 0.84 and 1.3% vs 1.2%, p = 0.58), whereas the percentage of patients who suffered from any complication (25.5% vs 31.9%, p = 0.012) and the complication rate (31.6% vs 45.2%, p=<0.01) were higher for octogenarians. At discharge, the values of EuroQoL5D were worse in group B, but after one month these levels became similar. Age >80 years had a significant influence on morbidity on both univariate and multivariable analyses (p = 0.025). Conclusions: VATS-L for NSCLC can be performed in selected octogenarians without increased risk of post-operative death, acceptable not-life-threatening complications and a moderate impact on QoL. Highlights: What are the outcomes thoracoscopic lobectomy for non-small-cell lung cancer? What is the impact of VATS-lobectomy on Quality of Life (QoL) in octogenarian patients? Post-operative complications were significantly more frequent, but not life-threatening. Levels of QoL were worse for elderly patients, but after a month these levels became similar. VATS-lobectomy can be safely performed in selected octogenarians, without worsening their QoL.