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

B. B. Pultrum*, D. J. Bosch, M. W. N. Nijsten, M. G. G. Rodgers, H. Groen, J. P. J. Slaets, J. Th. M. Plukker

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

84 Citaten (Scopus)
262 Downloads (Pure)

Samenvatting

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., a parts per thousand yen70 years) with outcome and evaluated age as a selection criterion for surgery.

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 a parts per thousand yen70 years (group II; 64 patients).

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).

Advanced age (a parts per thousand yen70 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.

Originele taal-2English
Pagina's (van-tot)1572-1580
Aantal pagina's9
TijdschriftAnnals of Surgical Oncology
Volume17
Nummer van het tijdschrift6
DOI's
StatusPublished - jun-2010

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