Perioperative outcomes and survival of octogenarians undergoing curative resection for esophagogastric adenocarcinoma

Abstract

Background and Objectives Current data are conflicting as to whether the outcomes of octogenarians undergoing resection for esophagogastric adenocarcinoma are comparable to younger patients. This study aims to compare perioperative outcomes and survival of patients ≥80 years old with younger patients undergoing curative resection for esophagogastric adenocarcinoma. Methods Retrospective data were collected on 190 patients who underwent resection with curative intent for adenocarcinomas found in the stomach and esophagogastric junction from 2004 to 2015 at a single institution. Results Of the 190 patients, 34 (18%) were ≥80 years old. Octogenarians were more likely to have chronic kidney disease (CKD) and were less likely to have received neoadjuvant chemotherapy. Pathologic features were similar between groups. Octogenarians' tumors were more likely to be located in the gastric body as compared to the esophagogastric junction in younger patients. Although the length of stay was comparable, octogenarians were significantly less likely to be discharged home (P < .01). Both groups had a single death during the index admission. Incidence and severity of 90 days postoperative complications were not significantly different between groups. There was no difference in 30‐day, 90‐day, 1‐year, or median survival. Conclusions Perioperative outcomes and survival of octogenarians undergoing curative resection for esophagogastric cancer are comparable to younger patients at our institution.

Esophageal Cancer in Elderly Patients, Current Treatment Options and Outcomes; A Systematic Review and Pooled Analysis

“…Twenty-three studies assessed postoperative pulmonary complications, with a median incidence of 20% (range 4.2–62.9%) for EP versus 16% (range 5.1–62.2%) for YP ( Table 1 ) [ 30 , 31 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. The most frequently reported pulmonary complication was pneumonia, which EP presented in significantly higher rates than their younger counterparts [ 31 , 33 , 34 , 37 , 38 , 40 , 48 , 50 , 52 ].…”

“…Eighteen studies assessed cardiovascular complications after esophagectomy for EP ( Table 1 ), with the most frequently reported event being cardiac arrythmia/atrial fibrillation [ 14 , 18 , 31 , 32 , 33 , 34 , 36 , 38 , 40 , 41 , 42 , 43 , 45 , 46 , 47 , 48 , 52 , 53 ]. The median incidence of cardiovascular complications was 15.6% (range 0–38.3) for EP and 7.0% (range 0–21) for YP, the difference was significant in 8 studies with EP having approximately twice the rate of YP [ 33 , 34 , 38 , 40 , 41 , 46 , 48 , 52 ].…”

“…In the four studies reporting the quality of surgery performed to EP compared to YP, there were no significant differences in terms of R0 resection [ 25 , 46 , 53 , 55 ]. Zehetner et al, however, reported less radical lymphadenectomy for EP (median resected lymph nodes = 24 vs. 37, p < 0.0001) [ 64 ].…”