In elderly patients with lung cancer is resection justified in terms of morbidity, mortality and residual quality of life?
In elderly patients with lung cancer is resection justified in terms of morbidity, mortality and residual quality of life?
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DOI：
10.1510/icvts.2010.233189
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发表时间：
2010-06-01
影响因子：
--
通讯作者：
Scarci, Marco
中科院分区：
文献类型：
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作者：
Chambers, Anthony;Routledge, Tom;Scarci, Marco
胸外科最佳证据主题是根据结构化协议编写的。问题是：在[70岁以上肺癌患者]中，[肺切除术]与[非手术治疗]相比，在[术后发病率、死亡率和生活质量]方面是否合理？使用报告检索共发现297篇论文，其中12篇代表了回答临床问题的最佳证据。将这些论文的作者、期刊、发表日期和国家、研究患者群体、研究类型、相关结果和结果列成表格。我们的结论是，在发病率、死亡率和剩余生活质量（QoL）方面，70岁以上的患者接受解剖性肺切除术的反应与年轻患者一样。对这些论文的集体分析显示，早期疾病（I期非小细胞肺癌：70年；59-78%）手术后的5年生存率没有显著差异，尽管老年患者目前接受姑息治疗的比例要高得多（65-70岁患者30-47%，65岁以下患者8%）。此外，30天死亡率（70年5.7%）、住院时间[分别为1.3天对1天（电视辅助小开胸术）和4.6天对4.9-5.2天（开胸术）]和术后肺功能测试（FEV下降；13% 70年P=0.34，功能肺活量下降；9% 70年P=0.31）在两个年龄组之间是相等的。肺叶切除术后的剩余生活质量（由患者自我评估评估）显示社会(P
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was: In [patients over 70 years of age with lung cancer] is [lung resection] when compared with [non-surgical treatment] justified in terms of [postoperative morbidity, mortality and quality of life]? Altogether more than 297 papers were found using the reported search, of which 12 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that patients over 70 years of age undergoing anatomical lung resection respond as well as younger patients in terms of morbidity, mortality and residual quality of life (QoL). Collective analysis of the papers reveals no significant difference in five-year survival rates following surgery for early stage disease (stage I non-small cell lung cancer: 70 years; 59-78%), although, elderly patients currently receive far higher rates of palliative care (30-47% in patients 65-70 years vs. 8% in patients under 65 years). Additionally, 30-day mortality rates (5.7% 70 years), length of hospital stay [1.3 days vs. 1 day (video-assisted mini-thoracotomy) and 4.6 vs. 4.9-5.2 days (thoracotomy) for 70 years, respectively] and postoperative lung function tests (FEV decrease; 13% 70 years P=0.34, functional vital capacity decrease; 9% 70 years P=0.31) are equivalent between the two age groups. Residual QoL following lobectomy (evaluated by patient self-assessment) showed decreased social (P