OBJECTIVE: The aim of this study was to examine the effect of age on the outcome of surgical treatment for carcinoma of the oesophagus and gastric cardia. METHODS: From 1979 to 1999, 596 patients underwent gastro-oesophagectomy with two-field lymph node clearance for cancer under the care of a single surgeon. The clinicopathologic characteristics and survival of patients aged between 45 and 63 years (n=198, Group 1), 63 and 71 years (n=199, Group 2) and 71 and 89 years (n=199, Group 3) were compared. RESULTS: Thirty-day mortality for the first 300 patients (1979-1993) in this consecutive series was 5, 8 and 18% for Groups 1, 2 and 3, respectively, and 6, 6 and 6% for Groups 1, 2 and 3, respectively, in the second consecutive 296 patients (1993-1999, P=0.006, chi(2)). Tumours were poorly differentiated in 55.7, 59.1 and 53.4% of patients in Groups 1, 2 and 3, respectively, for 1979-1993 and 64.7, 53.2 and 40.2% of tumours in Groups 1, 2 and 3, respectively, for 1993-1999 (P=0.02, chi(2)). Adjuvant therapy was significantly more common in younger patients (P=0.006, chi(2)). Five-year survival in the first period was 22, 15 and 11% for Groups 1, 2 and 3, respectively, (P=0.02 log-rank) and 18, 16 and 14% for Groups 1, 2 and 3 in the second period (P=NS, log-rank). CONCLUSIONS: Elderly patients now have equivalent short and long-term outcomes compared to younger patients following gastro-oesophagectomy. Five-year survival, even in younger patients receiving adjuvant therapy remains poor, however, at approximately 20%. New therapeutic modalities are required to improve long-term survival following surgical treatment of gastro-oesophageal carcinoma.
OBJECTIVE: The aim of this study was to examine the effect of age on the outcome of surgical treatment for carcinoma of the oesophagus and gastric cardia. METHODS: From 1979 to 1999, 596 patients underwent gastro-oesophagectomy with two-field lymph node clearance for cancer under the care of a single surgeon. The clinicopathologic characteristics and survival of patients aged between 45 and 63 years (n=198, Group 1), 63 and 71 years (n=199, Group 2) and 71 and 89 years (n=199, Group 3) were compared. RESULTS: Thirty-day mortality for the first 300 patients (1979-1993) in this consecutive series was 5, 8 and 18% for Groups 1, 2 and 3, respectively, and 6, 6 and 6% for Groups 1, 2 and 3, respectively, in the second consecutive 296 patients (1993-1999, P=0.006, chi(2)). Tumours were poorly differentiated in 55.7, 59.1 and 53.4% of patients in Groups 1, 2 and 3, respectively, for 1979-1993 and 64.7, 53.2 and 40.2% of tumours in Groups 1, 2 and 3, respectively, for 1993-1999 (P=0.02, chi(2)). Adjuvant therapy was significantly more common in younger patients (P=0.006, chi(2)). Five-year survival in the first period was 22, 15 and 11% for Groups 1, 2 and 3, respectively, (P=0.02 log-rank) and 18, 16 and 14% for Groups 1, 2 and 3 in the second period (P=NS, log-rank). CONCLUSIONS: Elderly patients now have equivalent short and long-term outcomes compared to younger patients following gastro-oesophagectomy. Five-year survival, even in younger patients receiving adjuvant therapy remains poor, however, at approximately 20%. New therapeutic modalities are required to improve long-term survival following surgical treatment of gastro-oesophageal carcinoma.
Authors: B B Pultrum; D J Bosch; M W N Nijsten; M G G Rodgers; H Groen; J P J Slaets; J Th M Plukker Journal: Ann Surg Oncol Date: 2010-02-24 Impact factor: 5.344
Authors: Luis F Tapias; Ashok Muniappan; Cameron D Wright; Henning A Gaissert; John C Wain; Christopher R Morse; Dean M Donahue; Douglas J Mathisen; Michael Lanuti Journal: Ann Thorac Surg Date: 2013-03-07 Impact factor: 4.330
Authors: Gregory Vlacich; Pamela P Samson; Stephanie M Perkins; Michael C Roach; Parag J Parikh; Jeffrey D Bradley; A Craig Lockhart; Varun Puri; Bryan F Meyers; Benjamin Kozower; Cliff G Robinson Journal: Cancer Med Date: 2017-11-15 Impact factor: 4.452