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01-11-2007 | Thoracic Oncology

Effects of Neoadjuvant Therapy on Perioperative Morbidity in Elderly Patients Undergoing Esophagectomy for Esophageal Cancer

Authors: Alberto Ruol, MD, FACS, Giuseppe Portale, MD, Carlo Castoro, MD, FACS, Stefano Merigliano, MD, Matteo Cagol, MD, Francesco Cavallin, PhD, Vanna Chiarion Sileni, MD, Luigi Corti, MD, Sabrina Rampado, Mario Costantini, MD, Ermanno Ancona, MD, FACS

Published in: Annals of Surgical Oncology | Issue 11/2007

Abstract

Background

The use of cytoreductive therapy followed by surgery is preferred by many centers dealing with locally advanced esophageal cancer. However, the potential for increase in mortality and morbidity rates has raised concerns on the use of chemoradiation therapy, especially in elderly patients. The aim of this study was to assess the effects of induction therapy on postoperative mortality and morbidity in elderly patients undergoing esophagectomy for locally advanced esophageal cancer at a single institution.

Methods

Postoperative mortality and morbidity of patients ≥70 years old undergoing esophagectomy after neoadjuvant therapy, between January 1992 and October 2005 for cancer of the esophagus or esophagogastric junction, were compared with findings in younger patients also receiving preoperative cytoreductive treatments.

Results

818 patients underwent esophagectomy during the study period. The study population included 238 patients <70 years and 31 ≥70 years old undergoing esophageal resection after neoadjuvant treatment. Despite a significant difference in comorbidities (pulmonary, cardiological and vascular), postoperative mortality and morbidity were similar irrespective of age.

Conclusions

Elderly patients receiving neoadjuvant therapies for cancer of the esophagus or esophagogastric junction do not have a significantly increased prevalence of mortality and major postoperative complications, although cardiovascular complications are more likely to occur. Advanced age should no longer be considered a contraindication to preoperative chemoradiation therapy preceding esophageal resection in carefully selected fit patients.

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Title: Effects of Neoadjuvant Therapy on Perioperative Morbidity in Elderly Patients Undergoing Esophagectomy for Esophageal Cancer
Authors: Alberto Ruol, MD, FACS
Giuseppe Portale, MD
Carlo Castoro, MD, FACS
Stefano Merigliano, MD
Matteo Cagol, MD
Francesco Cavallin, PhD
Vanna Chiarion Sileni, MD
Luigi Corti, MD
Sabrina Rampado
Mario Costantini, MD
Ermanno Ancona, MD, FACS
Publication date: 01-11-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 11/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9455-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of Neoadjuvant Therapy on Perioperative Morbidity in Elderly Patients Undergoing Esophagectomy for Esophageal Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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