Esophageal Cancer Surgery in Elderly Patients 80 Years of Age or Older

Abstract

As society ages, the elderly are increasingly affected by esophageal cancer. We reviewed the data of the elderly patients 80 years of age or older, who underwent surgery for esophageal cancer to evaluate the safety of surgery in this particular patient population.Nine patients aged 80 or above who underwent surgery for esophageal cancer in our department between 1999 and 2009 were included in this study. We analyzed their preoperative assessment, concurrent disorders, surgical techniques, postoperative course and complications. The patients' mean age was 82 years. Four patients had concurrent hypertension, two had concurrent diabetes, two had concurrent cerebral infarction, and two had undergone a malignant tumor operation. Three had obstructive pulmonary dysfunction, one had restrictive pulmonary dysfunction, and one had mixed pulmonary dysfunction. Clinical stage of esophageal cancer was graded as Stage I in one, Stage II in five, and Stage III in three patients. Four patients underwent esophagectomy with right thoracotomy and two-field lymph node dissection (LD), one underwent esophagectomy with right thoracotomy and three-field LD, one underwent esophagectomy with left thoracoabdominal incision and two-field LD, one underwent esophagectomy with left thoracotomy and two-field LD and two underwent transhiatal esophagectomy. Postoperative complications occurred in seven patients; however, no severe pneumonia or anastomotic leakage was noted. All patients were discharged with improved conditions. The mean postoperative hospital stay was 33 days. Esophageal cancer surgery can be performed safely in the oldest of elderly patients with appropriate preoperative assessment, selection of the optimal surgical technique, and pre- and postoperative patient management.