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Open Access 01-06-2010 | Gastrointestinal Oncology

Extended Esophagectomy in Elderly Patients with Esophageal Cancer: Minor Effect of Age Alone in Determining the Postoperative Course and Survival

Authors: B. B. Pultrum, MD, PhD, D. J. Bosch, BSc, M. W. N. Nijsten, MD, PhD, M. G. G. Rodgers, MD, H. Groen, MD, PhD, J. P. J. Slaets, MD, PhD, J. Th. M. Plukker, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2010

Abstract

Background

Elderly patients who undergo esophagectomy for cancer often have a high prevalence of coexisting diseases, which may adversely affect their postoperative course. We determined the relationship of advanced age (i.e., ≥70 years) with outcome and evaluated age as a selection criterion for surgery.

Methods

Between January 1991 and January 2007, we performed a curative-intent extended transthoracic esophagectomy in 234 patients with cancer of the esophagus. Patients were divided into two age groups: <70 years (group I; 170 patients) and ≥70 years (group II; 64 patients).

Results

Both groups were comparable regarding comorbidity (American Society of Anesthesiologists classification), and tumor and surgical characteristics. The overall in-hospital mortality rate was 6.2% (group I, 5%, vs. group II, 11%, P = 0.09). Advanced age was not a prognostic factor for developing postoperative complications (odds ratio, 1.578; 95% confidence interval, 0.857–2.904; P = 0.143). The overall number of complications was equal with 58% in group I vs. 69% in group II (P = 0.142). Moreover, the occurrence of complications in elderly patients did not influence survival (P = 0.174). Recurrences developed more in patients <70 years (58% vs. 42%, P = 0.028). The overall 5-year survival was 35%, and, when included, postoperative mortality was 33% in both groups (P = 0.676).The presence of comorbidity was an independent prognostic factor for survival (P = 0.002).

Conclusions

Advanced age (≥70 years) has minor influence on postoperative course, recurrent disease, and survival in patients who underwent an extended esophagectomy. Age alone is not a prognostic indicator for survival. We propose that a radical resection should not be withheld in elderly patients with limited frailty and comorbidity.

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Title: Extended Esophagectomy in Elderly Patients with Esophageal Cancer: Minor Effect of Age Alone in Determining the Postoperative Course and Survival
Authors: B. B. Pultrum, MD, PhD
D. J. Bosch, BSc
M. W. N. Nijsten, MD, PhD
M. G. G. Rodgers, MD
H. Groen, MD, PhD
J. P. J. Slaets, MD, PhD
J. Th. M. Plukker, MD, PhD
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 6/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-010-0966-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Extended Esophagectomy in Elderly Patients with Esophageal Cancer: Minor Effect of Age Alone in Determining the Postoperative Course and Survival

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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