Keyhole surgery opens options for elder patients

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http://www.cancerfacts.com/Home_News.as ... erTypeId=4

Source: (cancerfacts.com)

Wednesday, December 07, 2005

LOS ANGELES – Dec. 7, 2005 – A new study suggests that patients 80 years old and older with early stage lung cancer do benefit from so-called "keyhole" surgery to remove the affected section of lung tissue, provided they are in good health otherwise.

The study led by Dr. Robert McKenna, Jr., a thoracic surgeon and director of the Center for Chest Diseases at Cedars-Sinai Medical Center showed that patients in their 80s and even 90s did well following video-assisted throacoscopic surgery, which involves the surgeon removing cancerous lung sections through small incisions guided by video picture taken from inside the chest. The study results appear in the current issue of The American Surgeon..

"Our study shows that we can do a standard, complete lung cancer surgery in people over 80 with very low risk and good success so that older patients with lung cancer do not have to suffer the consequences of widespread cancer," McKenna said in a prepared statement.

When non-small cell lung cancers (NSCLC) are detected at an early, localized stage, surgical removal of the affected area often can prevent the cancer from spreading (metastasizing) to other tissues and organs.

Open surgery involves an eight- to 10-inch incision and continues to be used in about 95 percent of lung cancer surgeries nationally. Not all patients, including the elderly, however, are good candidates for the physical demands of open chest surgery. But for those who are, thoracoscopic surgery, offers shorter hospital stays, fewer surgery-related complications, and more rapid recovery.

McKenna and his colleagues, use the minimally invasive approach in 89 percent of their cases. Video-assisted thoracoscopic requires several small incisions through which instruments and a thoracoscope are inserted. A camera lens at the tip of the scope feeds high-resolution images to a video monitor, giving the surgeon a detailed, magnified view.

In the study, 159 patients between ages 80 and 94 underwent video-assisted thoracoscopic surgery. There were no surgery-related deaths and relatively few complications.

"Compared to the percentage of people who experience any type of complication after a major pulmonary resection, our numbers were low, and especially low for patients in this age range," said McKenna.

"Some patients and their doctors wonder why a person that age should bother to go through any major pulmonary surgery. The reason is that whether the patient is 80 or 95, if they are in reasonably good physical condition without any other major medical problems that are imminently life threatening, the odds are that the cancer is going to progress and the patient will live long enough to go through several unpleasant months with widespread cancer" he said.

Studies have shown that the average 80-year-old can expect to live another 8.6 years, but the average life expectancy of a patient with untreated early-stage non-small cell lung cancer is only 1.5 years.