Clinicopathologic characteristics of esophagectomy for esophageal carcinoma in elderly patients

Table 1 Clinicopathologic characteristics n (%)

Variables	≥70 years(n=60)	< 70 years(n=1782)	P value
	73.1 ± 3.9	55.8 ± 5.2	0.0007
Sex (male/female)	Sep-51	1453/329	0.61
Tumor location			0.74
Cervical	3 (5.0)	75 (4.2)
Upper-third	7 (11.7)	186 (10.4)
Middle-third	32 (53.3)	901 (50.6)
Lower-third	16 (26.7)	591 (33.2)
Double location	2 (3.3)	29 (1.6)
Tumor size (cm)	5.2 ± 2.1	6.5 ± 2.7	0.85
Histological type			0.87
Squamous cell carcinoma	53 (88.3)	1 610 (90.3)
Adenocarcinoma	4 (6.7)	97 (5.4)
Other carcinomas	3 (5.0)	75 (4.2)
Histological differentiation			0.76
Well	8 (13.3)	185 (10.4)
Moderately	46 (76.7)	1 410 (79.1)
Poorly	6 (10.0)	187 (10.5)
TNM stage			0.89
0	1 (1.7)	15 (0.8)
I	2 (3.3)	94 (5.3)
II	9 (15.0)	251 (14.1)
III	45 (75.0)	1 308 (73.4)
IV	3 (5.0)	114 (6.4)
Preoperative radiochemotherapy	19 (31.7)	624 (35.0)	0.68

Table 2 Preoperative risks n (%)

Risks	≥70 years (n=60)	< 70 years (n=1 782)	P value
Weight loss	17 (28.3)	564 (31.6)	0.67
Anemia	13 (21.7)	344 (19.3)	0.62
Hypertension	26 (43.3)	512 (28.7)	0.02
Pulmonary dysfunction	43 (71.7)	479 (26.9)	0
Cardiac disease	23 (38.3)	324 (18.2)	0
Cirrhosis	8 (13.3)	155 (8.7)	0.24
Chronic renal disease	11 (18.3)	236 (13.2)	0.25
Diabetes mellitus	24 (40.0)	395 (22.2)	0.003

Table 3 Surgical treatment n (%)

Variables	≥70 years (n=60)	<70 years (n=1782)	P value
Operation time (min)	239 ± 147	225 ± 139	0.88
Blood loss (mL)	443 ± 364	418 ± 251	0.41
Blood transfusion	23 (38.3)	415 (23.3)	0.01
Types of operations			0
Transthoracic esophagectomy	41 (68.3)	1 563 (87.7)
Transhiatal esophagectomy	17 (28.3)	190 (10.7)
Thoracoscopic esophagectomy	2 (3.3)	29 (1.6)
Organs in reconstruction			0.27
Stomach	53 (88.3)	1 435 (80.5)
Colon	3 (5.0)	197 (11.1)
Jejunum	4 (6.7)	150 (8.4)
Anastomotic site			0.31
Cervical	14 (23.3)	326 (18.3)
Intrathoracic	46 (76.7)	1 456 (81.7)
Curative resection	43 (71.7)	1 157 (64.9)	0.34

Table 4 Postoperative morbidity and mortality n (%)

Variables	≥70 years (n=60)	< 70 years (n=1782)	P value
Surgical complications
Anastomotic leakage	2 (3.3)	35 (2.0)	0.34
Hemorrhage	1 (1.7)	19 (1.0)	0.49
Intra-abdominal abscess	0 (0.0)	8 (0.4)	1
Chylothorax	2 (3.3)	39 (2.2)	0.39
Thoracic empyema	0 (0.0)	12 (0.7)	1
Recurrent nerve paralysis	1 (1.7)	20 (1.1)	0.5
Wound dehiscence	1 (1.7)	23 (1.3)	0.55
Medical complications
Pulmonary	26 (43.3)	501 (28.1)	0.01
Cardiac	23 (38.3)	352 (19.8)	0.001
Renal	1 (1.7)	46 (2.6)	1
Hepatic	0 (0.0)	15 (0.8)	1
Postoperative deaths	2 (3.3)	19 (1.1)	0.15
Anastomotic leakage	1 (1.7)	8 (0.4)	0.26
Pulmonary disease	1 (1.7)	9 (0.5)	0.28
Cerebrovascular accident	0 (0.0)	2 (0.1)	1

Table 5 Postoperative morbidity and mortality in elderly patients during the two periods n (%)

Variables	1990-1997 (n=17)	1998-2004 (n=43)	P value
Operation time (min)	255 ± 157	212 ± 104	0.008
Blood loss (mL)	520 ± 375	402 ± 249	0.003
Blood transfusion	13 (76.4)	19 (44.2)	0.04
Surgical complications
Anastomotic leakage	1 (5.9)	1 (2.3)	0.49
Hemorrhage	0 (0.0)	1 (2.3)	1
Chylothorax	1 (5.9)	1 (2.3)	0.49
Recurrent nerve paralysis	1 (5.9)	0 (0.0)	1
Wound dehiscence	0 (0.0)	1 (2.3)	1
Medical complications
Pulmonary	11 (64.7)	15 (34.9)	0.046
Cardiac	10 (58.8)	13 (30.2)	0.04
Renal	0 (0.0)	1 (2.3)	1
Hospital mortality rate	1 (5.9)	1 (2.3)	0.49