80歳以上患者における肺がん手術の安全性を確認(Mount Sinai Study Finds Lung Cancer Surgery Safe for Many Patients Over 80)

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2026-04-02 マウントサイナイ医療システム(MSHS)

米国のMount Sinai Health Systemの研究によると、80歳以上の高齢患者においても肺がん手術は多くの場合安全に実施可能であることが示された。従来は高齢であること自体が手術リスクと見なされがちだったが、患者の全身状態や合併症を適切に評価すれば、良好な手術成績が得られることが明らかになった。研究は、年齢のみで治療選択を制限すべきではなく、個別化された臨床判断の重要性を強調している。高齢化社会におけるがん治療戦略の見直しに重要な知見を提供する。

<関連情報>

早期非小細胞肺癌の80歳代患者における手術成績と生活の質:前向きコホート研究 Surgical outcomes and quality of life in octogenarians with early-stage non-small cell lung cancer: a prospective cohort study

Louis Gros ∙ Rowena Yip ∙ Wenchao Ma ∙ Jeffrey Zhu ∙ Jiafang Zhang ∙ Sydney Kantor ∙ et al.
The Lancet Regional Health – Americas  Published: March 13, 2026
DOI:https://doi.org/10.1016/j.lana.2026.101428

80歳以上患者における肺がん手術の安全性を確認(Mount Sinai Study Finds Lung Cancer Surgery Safe for Many Patients Over 80)

Summary

Background

As life expectancy increases, more adults aged ≥80 years are diagnosed with early-stage lung cancer. Often these patients are excluded from screening programs and clinical trials due to concerns about comorbidities and surgical risk as evidence on surgical outcomes and quality of life (QoL) remains limited. We aimed to compare postoperative outcomes, survival, and QoL between octogenarians and younger patients undergoing surgery for Stage IA NSCLC.

Methods

We included patients with stage IA non-small cell lung cancer from the Mount Sinai Health System enrolled in the prospective Initiative for Early Lung Cancer Research on Treatment (IELCART) study. Octogenarians (80 years and older) were compared to younger patients in terms of clinical presentation, type of surgery, postoperative outcomes, and survival. Quality of life was assessed using physical and mental health scores at baseline and at 1, 6, and 12 months after surgery. Lung cancer–specific and overall survival were analyzed using Kaplan–Meier methods.

Findings

Among 884 patients, 114 (12.9%) were octogenarians. Compared to 770 younger patients, octogenarians had similar comorbidities but underwent more frequently sublobar resections [90/114 (78.9%) vs. 485/770 (62.4%), p = 0.030] and had higher complication rates [46/114 (40%) vs. 168/770 (22%), p < 0.0001], particularly cardiovascular. Intensive care unit admissions and readmissions were slightly more frequent. In both age groups, physical and mental health declined at two months but improved by twelve months, with no significant differences. Five-year overall- and lung cancer-specific survival rates were similar between octogenarians and younger patients (overall: 84.2% vs. 87.3%, lung cancer–specific survival: 94.4% vs. 94.5%).

Interpretation

Among octogenarians with early-stage NSCLC, surgical treatment was associated with favorable safety and long-term quality-of-life outcomes in carefully selected patients.

Funding

This study was supported by generous grants from the Simons Foundation (International, Ltd.).

医療・健康
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