Outcome of elderly patients with oesophageal squamous cell carcinoma after surgery

Abstract

Oesophagectomy may have morbidity and mortality rates that severely compromise long-term survival in elderly patients. The aim of this study was to compare clinical outcomes in elderly patients with oesophageal squamous cell carcinoma (SCC) with those of younger controls. Elderly patients at least 70 years old with oesophageal SCC were matched 1 : 1 with controls aged less than 70 years according to sex, tumour stage, tumour location, histological grade, surgical approach, completeness of resection and surgical period. Co-morbidities, surgical complications, surgical mortality and long-term survival were compared. One hundred and thirty-six patients were included in each group. Surgical mortality was greater in the elderly group (5.9 versus 0.7 per cent; P = 0.036). Overall and disease-specific 5-year survival rates were worse among patients aged at least 70 years (30.0 versus 41.8 per cent, and 31.5 versus 44.7 per cent respectively), as were 10-year rates (13.7 versus 26.4 per cent, and 20.2 versus 29.0 per cent). Disease-free survival rates after 5 years (24.0 versus 35.5 per cent) and 10 years (12.3 versus 24.3 per cent) were not statistically significant (P = 0.076). Poor functional status may account for higher morbidity and mortality rates in elderly patients with oesophageal SCC. Acceptable perioperative mortality rates and substantial long-term survival can still be achieved. Elderly patients should not be denied oesophagectomy.