Colon and Rectal Surgery

Background Patients with T1N0 nonsmall cell lung cancer (NSCLC) are preferably treated by anatomic lobectomy. However, not all such patients are suitable for lobectomy due to their age or comorbidity. Our aim was to determine the results obtained following lobectomy, wedge resection (WR) or continuous hyperfractionated accelerated radiotherapy (CHART) in patients aged > 70 years. Patients 207 consecutive patients aged > 70 years, with pathologic stage 1 NSCLC in our unit between 1991 and 2001 were studied. Of these patients, 149 had a lobectomy, 47 had a WR and 19 had CHART. Follow-up was 100% complete. Results Analysis demonstrated the WR and CHART patients to have reduced pulmonary function (FEV1 59% and 52%, respectively, of predicted vs. 76%, P < 0.001) when compared to the lobectomy group but there were no differences among the groups with regard to mean age and histologic tumour type. There were no operative mortality among patients after WR; however, a 2.7% 30-day operative mortality among patients undergoing lobectomy ( P = 0.29). Kaplan-Meier survival curves at 1 and 5 years for patients undergoing WR, lobectomy and CHART was 95% and 56% Vs 94% and 59% Vs 82% and 38%, respectively ( P < 0.05). The frequency of local/ regional recurrence in the WR group (19.1%) was not significantly higher than in the lobectomy group (18.4%, P = 0.38) when compared to the CHART group (27%, P = 0.07). Conclusion Loco-regional recurrence and survival after WR and lobectomy in elderly patients with stage T1N0 NSCLC are comparable. Although the numbers are small, these data suggest that CHART is a reasonable treatment option for those who are suitable candidates for surgery. 73 01 RACS Annual Scientific Congress, 2003 ANZJ. SURG. 203; 73 (Suppl.) bstracts BEES SGML