title: Advances in esophageal surgery in elderly patients with thoracic esophageal cancer.
abstract: OBJECTIVE
  To justify esophagectomy for elderly patients.
  
  
  METHODS
  A total of 1,002 patients with thoracic esophageal cancer who underwent esophagectomy were divided into three groups: I (≤ 74 years old, n=898); II (75-79 years, n=81); and III (≥ 80 years, n=23). Historical changes were compared between the first surgical period (1964-1989) and the second period (1990-2011).
  
  
  RESULTS
  The morbidity rates were 40%, 41% and 26% in the respective groups. Pulmonary complications decreased historically in groups II and III (36% to 15% and 43% to 0%, respectively). The mortality was higher in the older groups (4.8%, 8.6% and 13.0%, respectively); however, there was a marked historical decrease in groups II (18.2% to 5.1%) and III (28.6% to 6.3%). The 5-year survival improved from 5% to 35% in group II and from 0% to 17% in group III.
  
  
  CONCLUSIONS
  The outcomes of esophagectomy for elderly patients have markedly improved, with acceptable mortality even in octogenarians.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. masarum@surg2.med.kyushu-u.ac.jp
authors.forename: Masaru
authors.initials: M
authors.lastname: Morita
authors.forename: Hajime
authors.initials: H
authors.lastname: Otsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawano
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kumashiro
authors.forename: Kenji
authors.initials: K
authors.lastname: Taketani
authors.forename: Yasue
authors.initials: Y
authors.lastname: Kimura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saeki
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ida
authors.forename: Eiji
authors.initials: E
authors.lastname: Oki
authors.forename: Eriko
authors.initials: E
authors.lastname: Tokunaga
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ikeda
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kusumoto
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D013899:Thoracic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed