Adenocarcinoma of the esophagus and esophagogastric junction in patients older than 70 years: Results of neoadjuvant radiochemotherapy followed by transthoracic esophagectomy
Adenocarcinoma of the esophagus and esophagogastric junction in patients older than 70 years: Results of neoadjuvant radiochemotherapy followed by transthoracic esophagectomy
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DOI：
10.1016/j.jviscsurg.2012.03.006
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发表时间：
2012-06-01
影响因子：
2.1
通讯作者：
Thomas, P. A.
中科院分区：
文献类型：
--
作者：
Camerlo, A.;D'Journo, X. B.;Thomas, P. A.
目的：局部晚期食管腺癌的标准治疗包括新辅助放化疗和手术切除。非常少的数据是关于这一战略的可行性，在患者年龄超过70岁的age.Patients和方法：1996年至2008年，118例患者进行了经胸食管癌淋巴结切除术的食管和贲门腺癌（Siewert I和II）。将这些患者分为三组进行比较：组I（年龄小于70岁，新辅助治疗后手术; n = 66）;组II（年龄大于或等于70岁，仅手术; n = 32）;组III（年龄大于或等于70岁，新辅助治疗后手术; n = 20）。共病，类型的干预，发病率，死亡率，生存率和生活质量的数据进行了analysed.Results：有三组之间的共病和术前评估没有差异。第I组和第III组患者的局部晚期肿瘤更多（P < 0.001）。建议的手术类型之间存在一些差异。Lewis-Santy食管切除术最常用（分别为90%、50%和65%）。90天死亡率分别为8%、15%和15%。三组之间术后肺部、心脏或消化道并发症的发生率无统计学显著差异。5年生存率和生活质量无差异。结论：老年食管腺癌患者（年龄70岁以上）的新辅助放化疗似乎并没有增加术后发病率或死亡率，也没有任何差异的生活质量，也没有任何影响生存，无论患者的年龄。(C)2012年Elsevier Masson SAS。All rights reserved.
Aim: The standard treatment of locally-advanced esophageal adenocarcinoma consists of neoadjuvant radiochemotherapy followed by surgical resection. Very little data are available concerning the feasibility of this strategy in patients older than 70 years of age.Patients and methods: Between 1996 and 2008, 118 patients underwent transthoracic esophagectomy with lymphadenectomy for adenocarcinoma of the esophagus and gastric cardia (Siewert I and II). These were divided into three groups for comparison: Group I (age less than 70 years, neoadjuvant treatment followed by surgery; n = 66); Group II (age greater or equal to 70 years, surgery alone; n = 32); Group III (age greater or equal to 70 years, neoadjuvant treatment followed by surgery; n = 20). Data concerning comorbidities, type of intervention, morbidity, mortality, survival and quality of life were analyzed.Results: There was no difference among the three groups with regard to comorbidity and preoperative evaluation. The patients in Groups I and III had more locally-advanced tumors (P < 0.001). There was some disparity between the types of surgery proposed. The Lewis-Santy esophagectomy was most commonly used (90%, 50%, and 65% respectively). The 90-day mortality was 8%, 15%, and 15% respectively. There was no statistically significant difference in the incidence of postoperative pulmonary, cardiac, or digestive complications among the three groups. No difference was found in 5-year survival and quality of life.Conclusions: Neoadjuvant radiochemotherapy for elderly patients (age above 70 years) with esophageal adenocarcinoma did not seem to increase postoperative morbidity or mortality, nor was there any difference in quality of life, nor any effect on survival, no matter what the age of the patient. (C) 2012 Elsevier Masson SAS. All rights reserved.