Abstract:
Objective To analyze the short-and long-term outcomes of elderly patients after esophagectomy by comparing preoperative comorbidities, postoperative complications, and survival rates among different age groups.
Methods We retrospectively reviewed the data of 253 patients who underwent esophagectomy from January to December 2010 in The First Affiliated Hospital of University of Science and Technology of China. Eighty-eight (34.8%) patients were aged < 60 years (group A), 145 (57.3%) were aged 60-75 years (group B), and 20 (7.9%) were aged ≥75 years (group C). The short-and long-term outcomes of the patients were analyzed.
Results There were significant differences in three group of patients with hypertension before operation (P < 0.05). There were statistically significant differences among all complications, major complications, pulmonary infection, arrhythmia, and respiratory insufficiency (P < 0.05), except for anastomotic leakage and other complications (P > 0.05). The mean follow-up was 50.7 months. The median overall survival and 1-, 3-, and 5-year overall survival rates were 68 months and 98.9%, 86.8%, and 69%, respectively, for group A; 61 months and 93.1%, 76.1%, and 51%, respectively, for group B; and 32 months and 63.3%, 46%, and 28.8%, respectively, for group C (P < 0.001). The median progression-free survival (PFS) and 1-, 3-, and 5-year PFS rates were 60 months and 98.86%, 85.2%, and 45.5%, respectively, for group A; 43 months and 87.6%, 53.1%, and 26.9%, respectively, for group B; and 11 months and 30%, 20%, and 10%, respectively, for group C (P < 0.001). The differences in survival rates between groups A and B, A and C, and B and C were statistically significant (P < 0.001). The multivariate analysis showed that age and TNM stage Ⅳ were independent risk factors for overall survival and PFS (P < 0.05).
Conclusions The long-term survival rate decreases significantly in elderly patients with esophageal cancer. In addition, age and advanced pathological stage of tumor are independent risk factors for long-term outcomes.