Esophagectomy in Elderly Patients With Esophageal Cancer

SummaryBackgroundThe number of elderly patients who undergo surgery for esophageal cancer is increasing as a result of longer life expectancy, but little is known about the morbidity and outcome of such procedures in the elderly. This study compared the results of surgery for evaluating the effect of age on esophageal cancer patients.MethodsPatients who underwent surgery with curative intent for esophageal cancer from January 1999 to July 2009 were included in this retrospective study. Data were compared between patients ≥70 years (elderly group) and patients <70 years old (younger group). Patient characteristics, hospital course, surgical mortality, morbidity, and survival were compared between patients in these two age groups.ResultsOf the 166 patients included, 35 (21.1%) were at least 70 years old (mean age, 75.2 years) and 131 (78.9%) were younger than 70 years old (mean age, 51.8 years). All 29 eligible elderly and 29 randomly selected, age-adjusted younger patients were included for a balanced comparison. The elderly group had significantly longer hospital stays (46 vs. 22 days) and a significantly higher incidence of surgical morbidity (51.7% vs. 20.7%). Cardiopulmonary-related complications were the main causes of operative morbidity in the elderly group. The elderly group also had higher performance state scores. On the basis of less adjuvant anticancer treatment received, the overall survival of elderly patients was comparable to their younger counterparts (12.1 vs. 12.7 months; p = 0.77).ConclusionThe results of this study suggest that curative surgery for esophageal cancer in elderly patients may result in comparable overall survival and greater, but acceptable, morbidity in comparison with younger patients. Our data suggest that age ≥70 years old should not be considered a counterindicator for curative surgery in esophageal cancer patients.