[Preoperative management of the aged patients with cancer of the esophagus].
The peak incidence of esophageal cancer is in the sixth decade, but the number of resections in patients older than 70 is increasing. 184 patients who underwent esophageal resections (C > or = 1) were divided into five groups according to age; Group A: under 50, B: 50s, C: 60s, D: 70s E: over 80. Five-year survival for Group D (20.5%) was much lower than other groups. Group E had better 1- and 2-year survival than Group D. Preoperative condition, stage and postoperative course were investigated in 145 patients who underwent subtotal esophagectomy with two-field lymphadenectomy and reconstruction with the stomach. In Group D, more respiratory dysfunction and abnormality of electrocardiogram were seen than Group C (p < 0.05) preoperatively. There was no difference in stage. Group D had higher incidence of postoperative pneumonia, abnormal ECG (p < 0.01) and delirium (p < 0.05). Group D had less cancer deaths and more deaths from other diseases. These results indicate that patients older than 70 should be called aged and it is safe to reduce the lymph node dissection in the upper mediastinum for these patients.
Koizumi
H
H
First Department of Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Aoyama
N
N
Tokunaga
M
M
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015996:Survival Rate