Esophagectomy for cancer in the patient aged 70 years and older.
BACKGROUND
Advanced age increases the risk of any major surgical intervention, particularly esophageal resection. High morbidity and increased mortality have been reported in operations for esophageal cancer in the elderly.


METHODS
To determine outcome, risk factors, and the advisability of esophageal resection in the elderly, a single-institution retrospective review was performed of esophagectomy for cancer over a 14-year period. From January 1, 1980, to December 31, 1993, 540 patients underwent esophageal resection for esophageal cancer. These patients were divided into two groups: group 1, n = 89, patients 70 years of age or older; and group 2, n = 451, patients younger than 70 years of age. The two groups were compared according to preoperative risk factors, morbidity rate, mortality rate, mean stay in the hospital after operation, and long-term survival.


RESULTS
Adenocarcinoma of the esophagogastric junction was the most common tumor in group 1 and was usually managed with a single incisional approach. There were no significant differences between the groups concerning morbidity (24.7% in group 1), mortality (7.8% in group 1), mean stay in the hospital (23.3 days in group 1), or long-term survival (59%, 23%, and 13% at 1, 3, and 5 years, respectively, in group 1).


CONCLUSIONS
These results suggest that esophagectomy can be performed in selected elderly patients without increasing morbidity or mortality and with long-term survival.
Jougon
J B
JB
Service de Chirurgie Thoracique, Hôpital du Haut-Lvêque, Pessac, France.
Ballester
M
M
Duffy
J
J
Dubrez
J
J
Delaisement
C
C
Velly
J F
JF
Couraud
L
L
D000230:Adenocarcinoma / Q000601:surgery*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome