Sheraz R Markar1, Donald E Low. 1. Department of Thoracic Surgery, Virginia Mason Medical Center, Seattle, WA, USA. sheraz_markar@hotmail.com
Abstract
PURPOSE: To assess short and long-term outcomes for patients aged ≥80 years undergoing esophagectomy for malignancy. METHODS: All patients undergoing esophagectomy for cancer between 1991 and 2011 had information prospectively entered into a database; patients were divided into elderly (≥80 years) and younger (<80 years) groups. RESULTS: Of the 500 patients included, 32 (6.4%) were ≥80 years of age. Octogenarians had increased Charlson comorbidity index and were less likely to receive neoadjuvant chemoradiotherapy (6.3 vs. 39.7%). Analysis of operative time, estimated blood loss, and length of intensive care unit and hospital stay revealed no significant differences between the groups. Patients ≥80 years old had increased total postoperative morbidity (68.8 vs. 44.9%), specifically arrhythmia (31.3 vs. 16.7%) and pneumonia (18.8 vs. 8.3%). There were no in-hospital mortalities in patients ≥80 years (0 vs. 0.4%), and there was no significant difference in overall survival between the groups (53.2 ± 9.1 vs. 77.6 ± 4.8 months; P = 0.58). Subset analysis demonstrated similar morbidity and length of hospital stay for patients between 70 and 79 years (n = 132) and those ≥80 years. CONCLUSIONS: Elderly patients undergoing esophagectomy are at greater risk of postoperative complications. However, there were no significant differences in other major parameters, including length of hospital stay, mortality, and survival, indicating that selected patients ≥80 years old can and should be assessed by an experienced surgeon.
PURPOSE: To assess short and long-term outcomes for patients aged ≥80 years undergoing esophagectomy for malignancy. METHODS: All patients undergoing esophagectomy for cancer between 1991 and 2011 had information prospectively entered into a database; patients were divided into elderly (≥80 years) and younger (<80 years) groups. RESULTS: Of the 500 patients included, 32 (6.4%) were ≥80 years of age. Octogenarians had increased Charlson comorbidity index and were less likely to receive neoadjuvant chemoradiotherapy (6.3 vs. 39.7%). Analysis of operative time, estimated blood loss, and length of intensive care unit and hospital stay revealed no significant differences between the groups. Patients ≥80 years old had increased total postoperative morbidity (68.8 vs. 44.9%), specifically arrhythmia (31.3 vs. 16.7%) and pneumonia (18.8 vs. 8.3%). There were no in-hospital mortalities in patients ≥80 years (0 vs. 0.4%), and there was no significant difference in overall survival between the groups (53.2 ± 9.1 vs. 77.6 ± 4.8 months; P = 0.58). Subset analysis demonstrated similar morbidity and length of hospital stay for patients between 70 and 79 years (n = 132) and those ≥80 years. CONCLUSIONS: Elderly patients undergoing esophagectomy are at greater risk of postoperative complications. However, there were no significant differences in other major parameters, including length of hospital stay, mortality, and survival, indicating that selected patients ≥80 years old can and should be assessed by an experienced surgeon.
Authors: Gregory O'Grady; Ahmer M Hameed; Tony C Pang; Emma Johnston; Vincent T Lam; Arthur J Richardson; Michael J Hollands Journal: World J Surg Date: 2015-08 Impact factor: 3.352
Authors: Sheraz R Markar; Hugh Mackenzie; Tom Wiggins; Alan Askari; Omar Faiz; Giovanni Zaninotto; George B Hanna Journal: Am J Gastroenterol Date: 2015-10-06 Impact factor: 10.864
Authors: Christopher C Stahl; Dennis J Hanseman; Koffi Wima; Jeffrey M Sutton; Gregory C Wilson; Samuel F Hohmann; Shimul A Shah; Daniel E Abbott Journal: J Gastrointest Surg Date: 2014-05-28 Impact factor: 3.452
Authors: Sheraz R Markar; Henner Schmidt; Sonia Kunz; Artur Bodnar; Michal Hubka; Donald E Low Journal: J Gastrointest Surg Date: 2014-04-29 Impact factor: 3.452