Effect of Octogenarian Status on Outcomes after Robotic-Assisted Pulmonary Lobectomy for Primary Lung Cancer
Mudit Dutta1, Eric M. Toloza2, Diep Nguyen1, Rahul Mhaskar1, Gregory Fishberger1, Joseph R. Garrett2, Carla Moodie2, Jenna Tew2, Jacques P. Fontaine2, Jobelle J.A.R. Baldonado2.
1USF Morsani College of Medicine, Tampa, FL, USA, 2Moffitt Cancer Center, Tampa, FL, USA.
OBJECTIVE: While a recent study compared outcomes after robotic, thoracoscopic, and open pulmonary lobectomy in octogenarians, analysis of outcomes in octogenarians compared to younger patients after robotic-assisted video-thoracoscopic lobectomy for primary lung cancer has not been well-studied.
METHODS: We retrospectively analyzed 1171 consecutive patients who underwent robotic-assisted pulmonary lobectomy over 10.8 years. Gender, preoperative FEV1, comorbidities, tumor characteristics, perioperative outcomes, 30-day mortality, and overall survival were compared using Chi-square, Fisher’s Exact, Wilcoxon, and Kruskal-Wallis tests, and Log-rank test to compare overall survival, with p≤0.05 as significant.
RESULTS: More octogenarians had hypertension (p=.001) than younger patients, while the younger patients had more active smokers (p<.0001) and chronic obstructive pulmonary disease (p=.002) than octogenarians. Lung cancer with pathologic stages IB, IIIB, and IV were more frequent in octogenarians than in younger patients. In contrast, pathologic stages IA, II, and IIIA were more frequent in younger patients (p=.0137). Octogenarians had higher postoperative rates of complications overall (p=.0336), aspiration (p=.0107), and atrial fibrillation (p=.0039) than younger patients. Octogenarians had longer chest tube duration (p=0.0375) and longer hospital length of stay (p=.0012) than younger patients. However, there was no significant difference between the two groups for 30-day mortality or overall survival. These results are depicted in Table 1 and Figure 1 below.
CONCLUSIONS: Octogenarian lung cancer patients may have more perioperative complications after undergoing robotic-assisted pulmonary lobectomies, but do not have increased 30-day mortality or worse overall survival than younger patients, which supports robotic-assisted pulmonary lobectomy as feasible and safe in octogenarians.
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