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. 2013 May;95(5):1741-8.
doi: 10.1016/j.athoracsur.2013.01.084. Epub 2013 Mar 7.

Short and long-term outcomes after esophagectomy for cancer in elderly patients

Luis F Tapias  1 , Ashok Muniappan, Cameron D Wright, Henning A Gaissert, John C Wain, Christopher R Morse, Dean M Donahue, Douglas J Mathisen, Michael Lanuti
Affiliations

Short and long-term outcomes after esophagectomy for cancer in elderly patients

Luis F Tapias et al. Ann Thorac Surg. 2013 May.

Abstract

Background: As worldwide life expectancy rises, the number of candidates for surgical treatment of esophageal cancer over 70 years will increase. This study aims to examine outcomes after esophagectomy in elderly patients.

Methods: This study is a retrospective review of 474 patients undergoing esophagectomy for cancer during 2002 to 2011. A total of 334 (70.5%) patients were less than 70 years old (group A), 124 (26.2%) 70 to 79 years (group B), and 16 (3.4%) 80 years or greater (group C). We analyzed the effect of age on outcome variables including overall and disease specific survival.

Results: Major morbidity was observed to occur in 115 (35.6%) patients of group A, 58 (47.9%) of group B, and 10 (62.5%) of group C (p = 0.010). Mortality, both 30-day and 90-day was observed in 2 (0.6%) and 7 (2.2%) of group A, 4 (3.2%) and 7 (6.1%) of group B, and 1 (6.3%) and 2 (14.3%) of group C, respectively (p = 0.032 and p = 0.013). Anastomotic leak was observed in 16 (4.8%) patients of group A, 6 (4.8%) of group B, and 0 (0%) of group C (p = 0.685). Anastomotic stricture (defined by the need for ≥ 2 dilations) was observed in 76 (22.8%) of group A, 13 (10.5%) of group B, and 1 (6.3%) of group C (p = 0.005). Five-year overall and disease specific survival was 64.8% and 72.4% for group A, 41.7% and 53.4% for group B, 49.2% and 49.2% for group C patients (p = 0.0006), respectively.

Conclusions: Esophagectomy should be carefully considered in patients 70 to 79 years old and can be justified with low mortality. Outcomes in octogenarians are worse suggesting esophagectomy be considered on a case by case basis. Stricture rate is inversely associated to age.

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Figures

Figure 1
Figure 1
Kaplan-Meier curve for overall survival after esophagectomy stratified by age group.
Figure 2
Figure 2
Kaplan-Meier curve for cancer-specific survival after esophagectomy stratified by age group.
See this image and copyright information in PMC

References

    1. Hvid-Jensen F, Pedersen L, Drewes AM, Sørensen HT, Funch-Jensen P. Incidence of adenocarcinoma among patients with Barrett’s esophagus. N Engl J Med. 2011;365(15):1375–83. - PubMed
    1. Bytzer P, Christensen PB, Damkier P, Vinding K, Seersholm N. Adenocarcinoma of the esophagus and Barrett’s esophagus: a population-based study. Am J Gastroenterol. 1999;94:86–91. - PubMed
    1. Wright CD, Kucharczuk JC, O’Brien SM, Grab JD, Allen MS. Society of Thoracic Surgeons General Thoracic Surgery Database. Predictors of major morbidity and mortality after esophagectomy for esophageal cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database risk adjustment model. J Thorac Cardiovasc Surg. 2009;137(3):587–95. - PubMed
    1. Poon RT, Law SY, Chu KM, Branicki FJ, Wong J. Esophagectomy for carcinoma of the esophagus in the elderly: results of current surgical management. Ann Surg. 1998;227(3):357–64. - PMC - PubMed
    1. Cijs TM, Verhoef C, Steyerberg EW, Koppert LB, Tran TC, Wijnhoven BP, et al. Outcome of esophagectomy for cancer in elderly patients. Ann Thorac Surg. 2010;90(3):900–7. - PubMed

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