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Prognostic Factors and Outcomes in Elderly Esophagectomy Patients with Esophageal Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Choosing the appropriate treatment for elderly patients with esophageal cancer remains a contentious issue. While surgery is still a valid option, we aimed to identify predictors and outcomes in elderly esophagectomy patients with esophageal cancer.

Patients and Methods

We analyzed characteristics, surgical outcomes, survival rates, cause-specific mortality, and recurrence in 120 patients with stage I–IV esophageal cancer. Univariate and multivariate analyses were used to identify risk factors for event-free survival (EFS) and overall survival (OS).

Results

The median follow-up period was 31 months, with 5-year overall survival (OS) and event-free survival (EFS) rates standing at 45.2% and 41.5%, respectively. Notably, lower body mass index (BMI ≤ 22 kg/m2) and reduced preoperative albumin levels (pre-ALB < 40 g/L) led to a significant decrease in OS rates. Postoperative pulmonary complications resulted in higher in-hospital and 90-day mortality rates. After about 31 months post-surgery, the rate of cancer-specific deaths stabilized. The most common sites for distant metastasis were the lungs, supraclavicular lymph nodes, liver, and bone. The study identified lower BMI, lower pre-ALB levels, and postoperative pulmonary complications as independent risk factors for poorer EFS and OS outcomes.

Conclusions

Esophagectomy remains a safe and feasible treatment for elderly patients, though the prevention of postoperative pulmonary infection is crucial. Factors such as lower BMI, lower pre-ALB levels, advanced tumor stage, postoperative pulmonary complications, and certain treatment modalities significantly influence the outcomes in elderly esophagectomy patients. These findings provide critical insights into the characteristics and outcomes of this patient population.

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Funding

This study was supported by the National Natural Science Foundation of China (grant no. 82002497) and Natural Science Foundation of Fujian Province (Nos. 2020J05072, 2020J011125, and 2021J01442).

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Author notes

  1. Peiyuan Wang and Mengxia Lei have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Thoracic Oncology Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China

    Peiyuan Wang MD, PhD, Yujie Chen MM, Hao He MM, Junpeng Lin MD, PhD, Hui Lin MM, Wenwei Wei MM, Peng Chen MD, Derong Zhang MB, Weijie Chen MM, Hang Zhou MM, Pengqiang Gao MM, Shuoyan Liu MB & Feng Wang MD

  2. Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, China

    Peiyuan Wang MD, PhD

  3. Fujian Provincial Key Laboratory of Tumor Biotherapy, Fuzhou, China

    Peiyuan Wang MD, PhD

  4. Department of Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China

    Mengxia Lei MD, PhD

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  1. Peiyuan Wang MD, PhD
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  2. Mengxia Lei MD, PhD
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Correspondence to Shuoyan Liu MB or Feng Wang MD.

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Wang, P., Lei, M., Chen, Y. et al. Prognostic Factors and Outcomes in Elderly Esophagectomy Patients with Esophageal Cancer. Ann Surg Oncol 31, 1553–1561 (2024). https://doi.org/10.1245/s10434-023-14634-6

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  • DOI: https://doi.org/10.1245/s10434-023-14634-6

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