Pneumonectomy for bronchogenic carcinoma in the elderly

Eur J Cardiothorac Surg. 1994;8(5):247-50. doi: 10.1016/1010-7940(94)90154-6.


We have reviewed 70 consecutive elderly patients (70 years or older) who underwent pneumonectomy for bronchogenic carcinoma, in order to evaluate morbidity, mortality, and long-term survival. The majority of the patients had stage II (n = 32) or III (n = 25) disease. Fifteen deaths occurred in the peri-operative period (21%). Pre-operative factors associated with peri-operative death included a history of ischaemic heart disease (P = 0.001) and right-sided tumour (peri-operative mortality for right pneumonectomy = 37%, left pneumonectomy = 6%, P = 0.001). Poor lung function (as assessed by pre-operative spirometry), peripheral vascular disease, cerebrovascular disease, diabetes mellitus, and hypertension were not significant risk factors for peri-operative death. Post-operatively, the requirement for ventilation, or the development of post-operative myocardial infarction, adult respiratory distress syndrome and respiratory failure were significantly associated with peri-operative death. Over 60% of the patients developed one or more complications. The absolute survival rates for operative survivors were 51% and 27% at 1 and 5 years, respectively (stage I, 60% and 40%; stage II, 63% and 33%; stage III 33% and 14%). The absolute overall survival rates were 40% and 21% at 1 and 5 years, respectively. We conclude that pneumonectomy is justified in elderly patients but right-sided lesions and ischaemic heart disease should be considered as relative contra-indications.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Bronchogenic / mortality
  • Carcinoma, Bronchogenic / pathology*
  • Carcinoma, Bronchogenic / surgery*
  • Female
  • Humans
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery*
  • Male
  • Morbidity
  • Neoplasm Staging
  • Pneumonectomy / mortality*
  • Pneumonectomy / statistics & numerical data
  • Postoperative Complications
  • Survival Rate