A Comparative Study Of Different Surgical Procedures In Elderly Patients With Stage?b Lung Cancer

Objective: To compare the different surgical procedures of patients with stage ?b elderly lung cancer,compare the recent surgical results and the recurrence and long-term survival rate of different surgical methods,and provide the basis for clinicians to treat such patients.Methods: In order to ensure adequate follow-up period,the time limit for this study was from January 2011 to December 2013.Patients were treated with thoracic surgery at the First Affiliated Hospital of Dalian Medical University,and the pathology was confirmed as lung cancer.There were 126 elderly patients.The age,sex,preoperative FEV1,smoking history,duration of operation,intraoperative blood loss,thoracic drainage time,postoperative recovery time,total length of stay,postoperative pathological grade,pathological type,T stage,pleural Violations and postoperative chemotherapy and other data for statistical analysis.The patients were divided into two groups: the sex,age,smoking history,pathological grade,pathological type,T stage,pleural invasion and postoperative complications were analyzed.The operation time,Drainage time,postoperative hospital stay,total length of hospital stay and other numerical variables were T test,respectively,the recurrence time and survival as the final observation results,Kaplan-Meier method for all cases of single factor analysis,and to draw the survival curve.Results: Among the 126 elderly patients with lung cancer,there were 60 patients with male patients,accounting for 47.6% of the total patients and 66 patients in the female patients,accounting for 52.4% of the total patients.65 patients aged 70-74 years,61 cases over 74 years of age.20 patients had previous history of smoking,106 patients had no history of smoking.Preoperative pulmonary function assessment of FEV1 accounted for more than 90% of the estimated percentage of patients in 63 cases,less than or equal to 90% of patients with 63 cases.89 patients underwent lobectomy,accounting for 71% of the total number of patients,37 patients underwent subtotal lobectomy,accounting for 29% of the total number of patients.The average operative time was 144.9 minutes for patients undergoing lobectomy,and the average duration of the operation was 111.2 minutes.In terms of average blood loss during surgery,patients with lobectomy had an average of 68.6 ml and an average of 33.6 ml in patients undergoing sub-lobectomy.Patients with lobectomy had an average postoperative time of 4.9 days and an average postoperative time was 3.6 days for patients undergoing primary lobectomy.The patients who underwent lobectomy had an average of 7.4 days from the date of surgery(postoperative recovery time),and 6.9 days from the date of operation to the discharge of patients with subtotal lobectomy.Patients with lobectomy had an average hospital stay of 14.3 days,slightly higher than 13.5 days in patients undergoing primary lobectomy.Patients with lobectomy had 24 patients with complications,accounting for 26.9% of the patients who underwent lobectomy.There were 5 patients(13.5%)with postoperative complications.The recurrence rate was 26% in patients who underwent lobectomy and 22% in patients undergoing primary lobectomy.The recurrence rates were 11%,20% and 50%,respectively.Adenocarcinoma recurrence rate of 21%,squamous cell carcinoma recurrence rate of 53%,only one case of large cell neuroendocrine cancer,the current health,no recurrence;and small cell carcinoma is only one case,still alive,no recurrence,here Not to discuss,because the number of cases is too little representative.The recurrence rates of T1 a,T1b,T1 c and T2 a were 0%,12%,26% and 58%,respectively.The recurrence rates for pleural invasion and pleural invasion were 67% and 21%,respectively.The overall 5-year survival rate was 78.6% in elderly patients with lung cancer.The 5-year survival rate was 78% in elderly patients with lung cancer who underwent lobectomy,and the 5-year survival rate was 84% in elderly patients with lung cancer who underwent primary lobectomy.The results were not statistically significant(P = 0.292).(P = 0.000).The results showed that there were significant differences between the two groups(P <0.05).Conclusion: The pathological changes of patients with pathological factors such as age,pathological grade,pathological type,T stage and pleural invasion were screened by Kaplan-Meier method.(P = 0.038),T stage(P = 0.001)and pleural invasion(P = 0.004).The five-year survival rates for high,medium and poor differentiation were 95%,84% and 56%,respectively.The five-year survival rate for adenocarcinoma and squamous cell carcinoma was 83% and 28%.The 5-year survival rates of T1 a,T1b,T1 c and T2 a were 100%,90%,79% and 50%,respectively.The five-year survival rates for pleural invasion and pleural invasion were 82% and 44%,respectively.Conclusion:1.For stage ?b elderly patients with lung cancer,T stage is an independent factor in determining the surgical approach.Patients with sub-lobectomy were superior to those undergoing lobectomy in terms of duration of operation,intraoperative blood loss and thoracic drainage time.2.There was a similar local recurrence rate and long-term prognosis in patients with stage ?b elderly patients with lung cancer,pathologic grade,pathological type and T stage.The patients with lung lobectomy and lobectomy had similar local recurrence rate and long-term prognosis.