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Outcomes of elderly patients following thoracoscopic esophagectomy for esophageal cancer

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Abstract

Purpose

Thoracoscopic esophagectomy (TE) is widely used for esophageal cancer treatment. However, the short- and long-term outcomes of TE in older patients remain unknown. Thus, we investigated those outcomes as well as the effectivity of TE in this patient cohort.

Methods

A total of 228 consecutive patients who underwent TE for esophageal cancer from 2002 to 2015 were included in the study and categorized into the elderly (≥ 75 years) and non-elderly (< 75 years) groups. The background was adjusted by propensity score matching. The short- and long-term outcomes were then compared between the two groups.

Results

There was no difference in the short-term outcomes between the two groups. The elderly group had significantly lower overall survival (OS) and relapse-free survival (RFS) than the non-elderly group. When pulmonary complications occurred, the OS and RFS were significantly decreased in the elderly group but not in the non-elderly group. Without pulmonary complications, the OS and RFS in the elderly group did not differ from those in the non-elderly group. The multivariate analysis showed that pulmonary complications were independent poor prognostic factors for OS and RFS in the elderly group but not in the non-elderly group.

Conclusion

TE is safe and feasible for older patients. However, the OS and RFS of the elderly group were significantly worse than those of the non-elderly group, especially when pulmonary complications occurred. Therefore, perioperative management to prevent pulmonary complications is essential to improve the long-term outcomes of older patients receiving TE.

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Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-Ku, Niigata prefecture, 950-1197, Niigata city, Japan

    Shirou Kuwabara, Kazuaki Kobayashi & Natsuru Sudo

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  1. Shirou Kuwabara
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  2. Kazuaki Kobayashi
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  3. Natsuru Sudo
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Contributions

Study conception and design: Shirou Kuwabara. Acquisition of data: Shirou Kuwabara, Kazuaki Kobayashi, and Natsuru Sudo. Analysis and interpretation of data: Shirou Kuwabara, Kazuaki Kobayashi, and Natsuru Sudo. Drafting of the manuscript: Shirou Kuwabara. Critical revision of the manuscript: Kazuaki Kobayashi and Natsuru Sudo.

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Correspondence to Shirou Kuwabara.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of Niigata City General Hospital (#21-064).

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The authors declare no competing interests.

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Kuwabara, S., Kobayashi, K. & Sudo, N. Outcomes of elderly patients following thoracoscopic esophagectomy for esophageal cancer. Langenbecks Arch Surg 408, 56 (2023). https://doi.org/10.1007/s00423-023-02797-5

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