Surgery for esophageal cancer in elderly patients: The view from Nottingham

Alexiou, Christos; Beggs, David; Salama, F D; Brackenbury, Edward T.; Morgan, William E.

doi:10.1016/s0022-5223(98)70159-x

Cited by 73 publications

(51 citation statements)

References 21 publications

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“…26,31,[34][35][36][37][38][39][40] There does appear to be an increase in overall mortality and a decrease in OS with advancing age. 39 However, when adjusted for comorbidities, the outcomes are similar across age groups.…”

Section: Surgery and Neoadjuvant Therapymentioning

confidence: 95%

The Impact of Age on Morbidity and Mortality following Esophagectomy for Esophageal Cancer

2013

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Section: Surgery and Neoadjuvant Therapymentioning

confidence: 95%

The Impact of Age on Morbidity and Mortality following Esophagectomy for Esophageal Cancer

2013

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“…In several studies, the influence of old age was investigated [44][45][46][47][48][49][50][51][52][53][54][55][56] . In a minority of studies, older age was associated with an unfavourable postoperative outcome 44;49;52;53;55;56. The use of a risk score may be a quality indicator.…”

Section: Patient Selectionmentioning

confidence: 99%

Quality-of-care indicators for oesophageal cancer surgery: A review

Staal

Wouters

Boot

et al. 2010

European Journal of Surgical Oncology

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“…There is no established cut-off to define a patient as 'elderly' in relation to surgery, but most studies available so far set the age limit at 70 [5][6][7][8][9][10][11][12][13][14]: all these studies conclude that surgical resection is justified in selected aged patients, mainly those aged between 70 and 75 years. If esophagectomy for this group of patients is nowadays accepted, less is reported on patients over 75 [15][16][17].…”

Section: Introduction and Aim Of The Studymentioning

confidence: 99%

Outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years☆

Internullo

Moons

Nafteux

et al. 2008

European Journal of Cardio-Thoracic Surgery

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Objective: Though the surgical treatment of esophageal cancer is increasingly accepted for elderly people defined as aged over 70 years, less is reported about the results in patients over 75. This study is a single institution retrospective analysis of outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years. Methods: All consecutive patients 76 years old and over undergoing curative esophagectomy for cancer in the period 1991-2006 were analyzed as to comorbidities, outcome and long-term survival. All the data had been prospectively collected in a database. Postoperative mortality risk was assessed by P-POSSUM and O-POSSUM score for in-hospital mortality and by the recently published Steyerberg's score system [Steyerberg EW, Neville BA, Koppert LB, Lemmens VEPP, Tilanus HW, Coebergh JWW, Weeks JC, Earle CC. Surgical mortality in patients with esophageal cancer: development and validation of a simple risk score. J Clin Oncol 2006;24:4277-84.] for 30-day mortality. Five-year survival was compared to the standardized survival in the general population. Results: One hundred and eight patients fulfilling the abovementioned criteria were found (76 males and 32 females, mean age 79.5 years, mean standardized life-expectancy: 7.36 years). Among them, 69% had esophageal tumors and 31% GEJ tumors. The predominant histology was adenocarcinoma (74%). Eighty-six (79.6%) presented with one or more major comorbidities or a history of previous major upper-GI surgery, potentially affecting the surgical outcome. All underwent resection with curative intent (R 0 83.3%, R 1 12%, R 2 4.6%). The overall postoperative morbidity rate was 51.9%, pulmonary complications (37%) being the most frequent. Postoperative mortality, mainly due to cardiopulmonary complications, was 7.4%, which was consistent with that predicted by P-POSSUM score (7.2%) and lower than that predicted by O-POSSUM score (15.1%). Thirty-day mortality was 5.5%, being consistent with that predicted by the Steyerberg's score (6.8%). Overall 5-year survival was 35.7%, while R 0 overall survival 42% and cancer specific R 0 survival 51.7%. Conclusions: Patients 76 years old and over with esophageal or GEJ cancer should not be denied surgery solely on the basis of age. Outcome and long-term results in the selected elderly are not differing from those reported for younger patients. However, despite thorough preoperative assessment being applied in the selection of the candidates for surgery, a practical and reliable individual riskanalysis stratification is still lacking. #

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Surgery for esophageal cancer in elderly patients: The view from Nottingham

Cited by 73 publications

References 21 publications

The Impact of Age on Morbidity and Mortality following Esophagectomy for Esophageal Cancer

The Impact of Age on Morbidity and Mortality following Esophagectomy for Esophageal Cancer

Quality-of-care indicators for oesophageal cancer surgery: A review

Outcome after esophagectomy for cancer of the esophagus and GEJ in patients aged over 75 years☆

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