The effect of age on the outcome of esophageal cancer surgery
The effect of age on the outcome of esophageal cancer surgery
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DOI：
10.4103/1817-1737.49415
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发表时间：
2009-04-01
影响因子：
2.3
通讯作者：
Karimian, Faramarz
中科院分区：
文献类型：
--
作者：
Alibakhshi, Abbas;Aminian, Ali;Karimian, Faramarz
背景：手术治疗仍是食管癌的最佳治疗方法。预期寿命的增加和食管肿瘤发病率的上升导致了大量的老年患者接受复杂的手术。本研究的目的是在一个高容量中心评价高龄（70岁或以上）对食管癌食管切除术手术结局的影响。材料和方法：2000年1月至2006年4月，480例食管癌患者在转诊的癌症研究所接受了食管切除术。老年组（70岁或以上）的165例患者与年轻组（70岁）的315例患者进行了比较。所有的住院发病率和死亡率进行了研究。结果：年龄38-84岁，平均58.7岁。老年组和年轻组的平均年龄分别为74岁和53.2岁。在年轻组中，70例患者（22.2）和老年组中，39例患者（23.6）出现并发症（P 0.72）。两组中最常见的并发症是肺部并发症（年轻组9.8例，老年组10.3例）（P 0.87）。两组的吻合口瘘和心脏并发症发生率也相似。年轻和老年患者的住院死亡率分别为2.8和3。两组患者的病死率比较差异无统计学意义（P> 0.05）.结论：随着经验和护理的增加，老年患者食管切除术的结局与年轻患者相当。高龄并不是食管切除术的禁忌症。
Background: Surgery is still the best way for treatment of esophageal cancer. The increase in life expectancy and the rising incidence of esophageal tumors have led to a great number of elderly candidates for complex surgery. The purpose of this study was to evaluate the effects of advanced age (70 years or more) on the surgical outcome of esophagectomy for esophageal cancer at a single high-volume center. Materials and Methods: Between January 2000 and April 2006, 480 cases with esophageal cancer underwent esophagectomy in the referral cancer institute. One hundred sixty-five patients in the elderly group (70 years old or more) were compared with 315 patients in the younger group ( 70 years). All in-hospital morbidity and mortality were studied. Results: The range of age was 38-84 years, with a mean of 58.7. The mean age of the elderly and younger groups was 74 and 53.2, respectively. In the younger group, 70 patients (22.2) and in the elderly group, 39 patients (23.6) were complicated (P0.72).The most common complications in the two groups were pulmonary complications (9.8 in younger and 10.3 in elderly) (P 0.87). Rates of anastomotic leakage and cardiac complications were also similar between the two groups. Hospital mortality rates in younger and elderly patients were 2.8 and 3, respectively. There was no significant difference between the two groups in morbidities and mortality (P -value > 0.05). Conclusions: With increased experience and care, the outcomes of esophagectomy in elderly patients are comparable to young patients. Advanced age alone is not a contraindication for esophagectomy.