Internullo E et al. – Pts >= age 76 yrs with esophageal or GEJ cancer may be surgical candidates based on findings of outcome and long-term results similar to those for younger pts; however, reliable individual risk-analysis stratification is still lacking Methods
Retrospective analysis of outcome after esophagectomy for cancer of the esophagus and GEJ in 108 pts age >= 75 yrs
Pts: 76 males/32 females; mean age 79.5 yrs; mean standardized life-expectancy: 7.36 yrs
Analysis of comorbidities, outcome, and long-term survival
Assessment of pstoperative mortality risk: P-POSSUM and O-POSSUM score for in-hospital mortality; Steyerberg's score system for 30-day mortality
Comparison of 5-yr survival with standardized survival in general population
Results
Esophageal tumors, 69% of pts; GEJ tumors, 31%
Predominant histology: adenocarcinoma (74%); >=1 major comorbidities or a history of previous major upper-GI surgery, potentially affecting surgical outcome in 86 pts (79.6%)
All underwent resection with curative intent (R0 83.3%, R1 12%, R2 4.6%)
Overall postoperative morbidity: 51.9%; pulmonary complications most frequent (37%)
Postoperative mortality: mainly due to cardiopulmonary complications, (7.4%); consistent with prediction by P-POSSUM score (7.2%); lower than prediction by O-POSSUM score (15.1%)
30-day mortality: 5.5%; consistent with prediction by Steyerberg's score (6.8%)
Overall 5-yr survival: 35.7%; R0 overall survival, 42%; cancer specific R0 survival, 51.7%
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