Is Overweight Related to the Prognosis of Octogenarians with Lung Cancer?

Obes Surg. 2022 Apr;32(4):1279-1288. doi: 10.1007/s11695-022-05948-7. Epub 2022 Feb 14.

Abstract

Background: This study aimed to determine outcomes and prognostic factors associated with octogenarians who underwent pulmonary resection for lung cancer.

Methods: From 2009 to 2018, 76 octogenarians who underwent pulmonary surgery for lung cancer were enrolled in this study. We divided them into two groups, namely overweight and non-overweight, and investigated their clinicopathological characteristics and outcomes. Disease-specific survival (DSS) rates were determined using Kaplan-Meier curves. Univariate and multivariate analyses were performed to identify prognostic factors.

Results: Although perioperative morbidity and mortality in octogenarians were not significantly different between the two groups, the long-term prognosis of the overweight group was significantly worse than that of the non-overweight group. The 3-year DSS rate was 56.5%. The median observation period after surgery was 37.5 (8.9-112.3) months for the entire cohort postoperatively. Kaplan-Meier curves showed that being overweight (body mass index ≥ 25) was associated with worse survival rates in all pathological stages (0 to III) and stage 0/I (DSS, p = 0.036 and p = 0.003, respectively). Multivariate analysis identified overweight as an unfavorable prognostic factor for DSS in patients with stage 0/I lung cancer (hazard ratio 2.240, 95% confidence intervals 1.052-4.564, p = 0.037).

Conclusions: Overweight is an independent risk factor, especially in pathological stage 0/I lung cancer. Indications for surgery should be carefully considered in elderly patients with obesity. However, owing to the limitations of this retrospective single-center study, future studies involving multiple institutions are required to confirm our findings.

Keywords: Lung cancer; Obesity; Octogenarian; Outcome; Surgery.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / surgery
  • Obesity, Morbid* / surgery
  • Octogenarians
  • Overweight / complications
  • Prognosis
  • Retrospective Studies