[Esophagectomy for carcinoma: impact of age on clinical results and survival].
Advances in perioperative management have allowed more and more elderly patients to undergo major surgery with postoperative morbidity and mortality rates similar to those of younger individuals. The aim of this study was to evaluate the impact of age on the clinical outcome and long-term survival of patients with oesophageal cancer undergoing oesophagectomy. Eight hundred and seventy-five patients with oesophageal carcinoma were divided into two groups: A (n = 393) aged > or = 65 years, and B (n = 482) aged < 65 years. One hundred and forty-nine (38%) patients in group A underwent surgery compared to 263 (55%) in group B (P < 0.01). Postoperative mortality and the prevalence of anastomotic leak and respiratory complications were similar in both groups. There was, however, a higher prevalence of cardiovascular complications in group A (13% versus 3%, P < 0.01). Five-year survival was about 35% in both groups. In conclusion, advanced age should not be considered a contra-indication to oesophagectomy for carcinoma, since the long-term survival of elderly patients undergoing resection is similar to that of younger ones.
Bonavina
Luigi
L
Dipartimento di Scienze Chirurgiche, Università degli Studi di Milano.
Incarbone
Raffaello
R
Saino
Greta
G
Peracchia
Alberto
A
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012737:Sex Factors; D016019:Survival Analysis