# Is Chest Wall Resection Safe in Geriatric Non‐Small Cell Lung Cancer?

## TL;DR

This study shows that chest wall surgery for lung cancer is safe for elderly patients, with survival rates not significantly affected by age.

## Contribution

The study demonstrates that advanced age does not increase surgical risks or reduce survival in chest wall resection for lung cancer.

## Key findings

- Geriatric patients had a 93% survival rate, not significantly different from younger patients.
- Complication risk was more influenced by the number of ribs removed than patient age.
- Pneumonectomy was associated with significantly lower survival compared to lobectomy.

## Abstract

Our aim in this study is to evaluate the safety and efficacy of surgery in patients undergoing chest wall resection due to non‐small cell lung cancer (NSCLC) based on age groups.

The study was conducted retrospectively on 160 patients with NSCLC who underwent chest wall resection between 2009 and 2019. Patients were classified into Group A (under 70 years) and Group B (70 years and older).

The study found a complication rate of 28.1%, but no negative impact of the geriatric age group on complications was determined. The risk of complications varied depending on the number of ribs removed (p = 0.035). The survival rate for Group A was 72%, while for Group B it was 93% (p = 0.189). No significant differences were found in terms of gender, Charlson Comorbidity Index (CCI), and histopathological results. In patients who underwent lobectomy, survival was 85%, while a significant difference was observed in those who underwent pneumonectomy, with a survival rate of 41% (p < 0.001).

It was determined that advanced age is not a prognostic factor in surgical resection regarding complications and survival, with the most important prognostic factors being the type of resection and the stage of the disease.

Chest wall resection can be performed safely, even in cases involving extensive invasion, including wide chest wall tumors. Our findings support the feasibility and safety of en bloc resection and reconstruction in appropriately selected elderly patients. Perioperative images demonstrating the reconstruction of the extensively invaded chest wall are presented in the figure.