Analysis of short-and long-term outcomes after esophagectomy in elderly cancer pa-tients / 中国肿瘤临床

ABSTRACT

Objective:To analyze the short-and long-term outcomes of elderly patients after esophagectomy by comparing preopera-tive 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 sig-nificant 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 sur-vival 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.