ESOPHAGECTOMY FOR CANCER IN THE PATIENT AGED 70 YEARS AND OLDER

Background. Advanced age increases the risk of any major surgical inte rvention, particularly esophageal resection. High morbidity and increa sed mortality have been reported in operations for esophageal cancer i n the elderly. Methods. To determine outcome, risk factors, and the ad visability of esophageal resection in the elderly, a single-institutio n retrospective review was performed of esophagectomy for cancer over a 14-year period. From January 1, 1980, to December 31, 1993, 540 pati ents underwent esophageal resection for esophageal cancer. These patie nts were divided into two groups: group 1, n = 89, patients 70 years o f age or older; and group 2, n = 451, patients younger than 70 years o f age. The two groups were compared according to preoperative risk fac tors, morbidity rate, mortality rate, mean stay in the hospital after operation, and long-term survival. Results. Adenocarcinoma of the esop hagogastric junction was the most common tumor in group 1 and was usua lly managed with a single incisional approach. There were no significa nt differences between the groups concerning morbidity (24.7% in group 1), mortality (7.8% in group 1), mean stay in the hospital (23.3 days in group 1), or long-term survival (59%, 23%, and 13% at 1, 3, and 5 years, respectively, in group 1). Conclusions. These results suggest t hat esophagectomy can be performed in selected elderly patients withou t increasing morbidity or mortality and with long-term survival. (C) 1 997 by The Society of Thoracic Surgeons.