A prognostic analysis of lung cancer surgery in super-elderly patients: a multicenter real-world data study
- 1Department of Thoracic Surgery, Okayama Rosai Hospital, Okayama, Japan
- 2Okayama University Thoracic Surgery Study Group, Okayama, Japan
- 3Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1, Shikata-cho, kita-ku, Okayama, 700-8558 Japan
Abstract
Purpose: With an increasing life expectancy, pulmonary resection is increasingly performed in super-elderly patients with lung cancer; however, the prognostic factors remain unclear. This study evaluated the postoperative survival and prognostic factors in patients aged ≥ 85 years.
Methods: This multicenter retrospective study included 209 patients aged ≥ 85 years who underwent pulmonary resection with curative intent between 2006 and 2015. Clinical variables, including the pulmonary function, comorbidity, nutritional status, and sarcopenia, were analyzed. Survival was evaluated using the Kaplan–Meier and Cox proportional hazards models.
Results: The median age was 86 years, and 119 patients (57.0%) were male. The main surgical procedures were lobectomy in 124 patients, segmentectomy in 37, and wedge resection in 47 patients. The 3-year overall survival (OS) rate was 63.6%, and the median OS was 46.5 months. A multivariate analysis identified male sex and reduced vital capacity as independent predictors of a poor survival. In clinical stage I patients, wedge resection was associated with a poorer survival than anatomical resection, although the baseline characteristics differed between the groups.
Conclusions: Pulmonary resection may be feasible in carefully selected super-elderly patients. A male sex and reduced vital capacity were associated with poorer outcomes, whereas chronological age was not significantly associated with OS in this cohort.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03431-9.
Related
- Prognostic Significance and Clinical Robustness of the HALP Score in Super-Elderly Patients Undergoing Curative Gastrectomy for Gastric Cancer: A Multicenter Retrospective Cohort Study.
- Development and internal validation of a prognostic model for cancer-specific survival in elderly patients with metastatic non-small cell lung cancer: a SEER-based study
- Early surgery for strangulated and non-strangulated small bowel obstruction has no advantages over delayed procedure, especially in elderly patients: results of a multicenter retrospective cohort study.
- Intelligent thermoregulation strategy versus routine thermal management on myocardial injury after noncardiac surgery during gastrointestinal tumor resection in elderly patients (SAGE): a multicenter, parallel-group, superiority trial.
- Stress hyperglycemia ratio is associated with delirium in elderly cardiac surgery patients in the postoperative intensive care unit: a multicenter retrospective cohort study.
BibTeX
@article{hayama2026prognostic,
title = {{A prognostic analysis of lung cancer surgery in super-elderly patients: a multicenter real-world data study}},
author = {Makio Hayama and Mikio Okazaki and Ken Suzawa and Kazuhiko Shien and Toshiya Fujiwara and Yuji Hirami and Mototsugu Watanabe and Daisuke Okutani and Hitoshi Nishikawa and Tsuyoshi Ueno and Shinji Otani and Eisuke Matsuda and Hiroshi Yaginuma and Shinichi Toyooka},
journal = {Surgery Today},
year = {2026},
month = jul,
doi = {10.1007/s00595-026-03431-9},
url = {https://doi.org/10.1007/s00595-026-03431-9},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A prognostic analysis of lung cancer surgery in super-elderly patients: a multicenter real-world data study
AU - Makio Hayama
AU - Mikio Okazaki
AU - Ken Suzawa
AU - Kazuhiko Shien
AU - Toshiya Fujiwara
AU - Yuji Hirami
AU - Mototsugu Watanabe
AU - Daisuke Okutani
AU - Hitoshi Nishikawa
AU - Tsuyoshi Ueno
AU - Shinji Otani
AU - Eisuke Matsuda
AU - Hiroshi Yaginuma
AU - Shinichi Toyooka
PY - 2026
DA - 2026/07/24
JO - Surgery Today
DO - 10.1007/s00595-026-03431-9
UR - https://doi.org/10.1007/s00595-026-03431-9
AB - Purpose: With an increasing life expectancy, pulmonary resection is increasingly performed in super-elderly patients with lung cancer; however, the prognostic factors remain unclear. This study evaluated the postoperative survival and prognostic factors in patients aged ≥ 85 years. Methods: This multicenter retrospective study included 209 patients aged ≥ 85 years who underwent pulmonary resection with curative intent between 2006 and 2015. Clinical variables, including the pulmonary function, comorbidity, nutritional status, and sarcopenia, were analyzed. Survival was evaluated using the Kaplan–Meier and Cox proportional hazards models. Results: The median age was 86 years, and 119 patients (57.0%) were male. The main surgical procedures were lobectomy in 124 patients, segmentectomy in 37, and wedge resection in 47 patients. The 3-year overall survival (OS) rate was 63.6%, and the median OS was 46.5 months. A multivariate analysis identified male sex and reduced vital capacity as independent predictors of a poor survival. In clinical stage I patients, wedge resection was associated with a poorer survival than anatomical resection, although the baseline characteristics differed between the groups. Conclusions: Pulmonary resection may be feasible in carefully selected super-elderly patients. A male sex and reduced vital capacity were associated with poorer outcomes, whereas chronological age was not significantly associated with OS in this cohort. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03431-9.
SN - 0941-1291
SN - 1436-2813
ER -