The reason is that whether the patient is 80 or 95, if they are in reasonably good physical condition without any other major medical problems that are imminently life threatening, the odds are that the cancer is going to progress and the patient will live long enough to go through several unpleasant months with widespread cancer," said Robert McKenna Jr., M.D., thoracic surgeon, surgical director of the Center for Chest Diseases and chief of Thoracic Surgery and Trauma at Cedars-Sinai.
"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 McKenna
, senior author of the journal article.
According to previous studies, 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.
"If you knew that you could get several additional years to live by having a procedure with low risk and good success in preventing widespread cancer, you might want the option of putting up with the short-term inconvenience of having that operation," McKenna
In the study, there were no surgery-related deaths and relatively few complications.
"Compared to the percentage of people who experience any type of complication after a major pulmonary resection, our numbers were low, and especially low for patients in this age range," said McKenna
Open surgery - accomplished through an eight- to 10-inch incision - continues to be used in about 95 percent of lobectomies nationally.
colleagues at Cedars-Sinai
, however, use the minimally invasive approach in 89 percent of their cases.
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 mages to a video monitor, giving the surgeon a detailed, magnified view.
"We have been doing minimally invasive lung cancer surgery for a long time and have the largest experience in the world," said McKenna, a pioneer in the development and use of the technology who has performed VATS procedures since 1989.