Lung Surgery for Octogenarians

Elderly patients who have early stage non-small cell lung cancer (NSCLC) can benefit from a minimally invasive surgical procedure to remove part or all of a lung, according to a study conducted by thoracic surgeons at Cedars-Sinai Medical Center (Los Angeles, CA).

When non-small cell lung cancers, which account for about 75% of all lung cancers, are detected at an early, localized stage, surgical removal of the affected area often can prevent metastasis to other tissues and organs.

While open surgery continues to be used in about 95% of lobectomies nationally, elderly patients might not be good candidates for the physical demands of open chest surgery. Dr. Robert McKenna Jr., a thoracic surgeon and chief of thoracic surgery and trauma at Cedars-Sinai, and his colleagues at Cedars-Sinai, however, use a minimally invasive approach in 89% of their cases.

Video-assisted thoracoscopic surgery (VATS) requires only several small incisions through which instruments and a thoracoscope are inserted. A camera lens at the tip of the scope feeds high-resolution images to a video monitor, giving the surgeon a detailed, magnified view.

"Our study shows that we can do a standard, complete lung cancer surgery in people over 80 with very low risk and good success so that older patients with lung cancer do not have to suffer the consequences of widespread cancer,” said Dr. McKenna, who led the study.

The average 80-year-old can expect to live another 8.6 years, but the average life expectancy of a patient with untreated or palliated early-stage NSCLC is only 1.5 years.

"We have been doing minimally invasive lung cancer surgery for a long time and have the largest experience in the world,” Dr. McKenna added. Dr. McKenna is a pioneer in the development and use of the technology.



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Cedars-Sinai Medical Center