title: The influence of age on mortality and survival in patients undergoing oesophagogastrectomies. A seven-year experience in a tertiary centre.
abstract: The aim of this study was to evaluate the effects of advanced age on the outcome and survival of patients undergoing oesophagectomy for oesophageal cancer at a single high-volume centre. We retrospectively reviewed the hospital survival of 326 patients in oesophagogastrectomies (OGs) in a period from May 2001 to April 2008. We divided the patients into two groups. Group A (n=218) consisted of patients younger than 70 years of age, while Group B (n=108) consisted of patients 70 years of age or older. The two groups were comparable. In-hospital mortality for Group A was 11 out of 218 (5%), while in-hospital mortality for Group B was 13 out of 108 (12%). This difference was statistically significant (P=0.024). Multivariate analysis showed that risk factors for in-hospital mortality after OG included age over 70 years [odds ratio (OR)=2.79], reduced % of predicted FEV(1) (OR=0.13) and cardiac co-morbidity (OR=2.53). Despite age over 70 years proving not to be predictive of survival (P=0.21), significant independent predictors were advancing age [hazard ratio (HR)=1.03] and stage of disease (HR=1.84). P-values were 0.0278 and 0.018, respectively. Increasing age is a significant risk factor for mortality and survival after oesophageal resection operations. This mortality is particularly high if associated with a preoperative cardiac or respiratory morbidity.
authors.affiliation: Department of Thoracic Surgery, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool L14 3PE, UK. hanyhassan77@hotmail.com
authors.forename: Hany
authors.initials: H
authors.lastname: Elsayed
authors.forename: Ian
authors.initials: I
authors.lastname: Whittle
authors.forename: James
authors.initials: J
authors.lastname: McShane
authors.forename: Nathan
authors.initials: N
authors.lastname: Howes
authors.forename: Mark
authors.initials: M
authors.lastname: Hartley
authors.forename: Michael
authors.initials: M
authors.lastname: Shackcloth
authors.forename: Richard
authors.initials: R
authors.lastname: Page
mesh_terms: D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D004739:England / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000401:mortality*; D005541:Forced Expiratory Volume; D005743:Gastrectomy / Q000009:adverse effects / Q000401:mortality*; D006331:Heart Diseases / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008171:Lung Diseases / Q000401:mortality / Q000503:physiopathology; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome