title: Achieving long term survival in oesophagectomy patients aged over 75.
abstract: OBJECTIVE
  Surgical resection is often the only curative treatment for oesophageal cancer. The aim of this retrospective cohort study was to analyse outcomes following oesophageal resection in patients aged 75 years and older and the impact of an Enhanced Recovery after Surgery (ERAS) program in this cohort.
  
  
  METHODS
  Patients aged over 75 years undergoing oesophagectomy between 2003 and 2013 were identified from a single centre using an electronic database. Data on pre-operative comorbidity, tumour stage and length of hospital stay (LOS) were collected. Complications were classified according to the Clavien-Dindo system. Thirty day, 1- and 5-year mortality rates were calculated.
  
  
  RESULTS
  147 patients were identified with a median age of 78.5 (IQR 76.7-80.9). 33% (n = 44) had a grade 3 complication or higher. Median LOS in hospital was 16 days (IQR 13.0-22.0). Thirty-day mortality was 3.4%, 1-year and 5-year survival was 65% and 21% respectively. 45% of patients were enrolled into an Enhanced Recovery After Surgery program and they demonstrated a significantly reduced length of stay from 18 to 14 days (p = 0.005) and 30-day mortality from 6.2% to 0% (p = 0.04) compared to the time period before the program.
  
  
  CONCLUSIONS
  Long-term survival is achievable in patients aged over 75 years.
authors.affiliation: Department of Upper GI Surgery, Nottingham City Hospital Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Oakley
authors.affiliation: Department of Upper GI Surgery, Nottingham City Hospital Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Lamb
authors.affiliation: Department of Upper GI Surgery, Nottingham City Hospital Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK.
authors.forename: Ravinder
authors.initials: R
authors.lastname: Vohra
authors.affiliation: Department of Upper GI Surgery, Nottingham City Hospital Campus, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK.
authors.forename: James
authors.initials: J
authors.lastname: Catton
keywords: Oesophageal cancer; Oesophagectomy