Lung Cancer Surgery for Patients Aged 85 Years and Older: A Retrospective Study

With the progressive aging of society, the incidence of lung cancer among elderly patients is increasing. However, surgical outcomes in patients aged ≥85 years remain unclear. We retrospectively reviewed 2,449 patients who underwent pulmonary resection for primary lung cancer at our institution between 2009 and 2023. Of these, 77 (3.1%) were aged ≥85 years. Clinical characteristics, perioperative complications, overall survival (OS), disease-specific survival (DSS), and follow-up status were analyzed as of April 2025. Patients who became unable to attend outpatient visits due to a decline in activities of daily living (ADL) were defined as “dropouts.” Perioperative complications occurred in 6.5%, including one perioperative death (1.3%) due to acute exacerbation of interstitial pneumonia. Short-term outcomes were favorable compared with previous reports, and long-term survival was not inferior. The 5-year OS rate was 43.9%, and the median survival time was 52 months. The 5-year DSS rate was 67.6%. At 5 years after surgery, 72.7% of patients had dropped out of follow-up due to death or functional decline, including deterioration of ADL.v Pulmonary resection can be safely performed in carefully selected patients aged ≥85 years. However, because approximately three-quarters became unable to continue follow-up within 5 years, careful preoperative explanation and informed consent are essential.