{'fraction_non_alphanumeric': 0.06788079470198675, 'fraction_numerical': 0.041390728476821195, 'mean_word_length': 4.905537459283388, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Surgery for elderly early-stage non-small cell lung cancer: less or more?

Introduction: Guidelines recommend lobectomy for early-stage non-small cell lung cancer(NSCLC). However, comorbidities and lung function can limit resection in older patients. We aimed to evaluate the outcomes of sublobar resection(SLR) on elderly patients. Methods: We assessed all patients aged over 70 years submitted to complete resection for early-stage NSCLC over a 5-year period in our centre. We compared SLR and non-SLR groups on demographics, smoking, performance status, comorbidities, lung function, preoperative blood tests, histology, staging, ressected lymph nodes (LN), margins, and postoperative complications. Disease-free survival(DFS) and overall survival(OS) were assessed and compared. Survival was analyzed using univariate log-rank and multivariate Cox tests. Results: SLR was performed in 18 (24.3%) of 74 patients. Non-SLR patients had more resected LN (p=0.04). 5-year DFS was 70%(CI 52 to 81) in non-SLR and 91%(CI 51 to 99) in SLR group. Procedure was not an independent DFS predictor. On the univariable analysis, albumin (p=0.045), C-reactive protein (CRP) (p=0.042) and pleural invasion (p=0.012) were predictors. On multivariable analysis, only albumin (p=0.020), platelets (p=0.032) and pleural invasion (p=0.013) remained. 5-year OS was 55%(CI 35 to 71) in non-SLR and 77%(CI 44 to 92) in SLR group. Procedure was not an OS predictor. A positive association was found with pleural invasion (p=0.006) on univariable analysis; and pleural invasion (p=0.028) and CRP (p=0.048) on multivariate analysis. Conclusion: Survival was not dependent on procedure type in our elderly population. This data is in line with the effectiveness of SLR in this age group and reinforces it as an alternative to lobectomy.