%0 Journal Article
%T Is Surgery in the Elderly for Oesophageal Cancer Justifiable? Results from a Single Centre
%A A. Mirza
%A S. Pritchard
%A I. Welch
%J ISRN Surgery
%D 2013
%R 10.1155/2013/609252
%X Aims. Advanced age is an identified risk factor for patients undergoing oncological surgical resection. The surgery for oesophageal cancer is associated with significant morbidity and mortality. Our aim was to study the operative management of elderly patients (¡Ý70 years) at a single institute. Methods. The data was collected from 206 patients who have undergone operative resection of oesophageal cancer. The demographic, operative, histological, and postoperative follow-up of all patients were analysed. Results. A total of 46 patients of ¡Ý70 years who had surgical resection for oesophageal cancer were identified. Patients ¡Ý70 years had poor overall survival ( ). Also elderly patients with nodal involvement had poor survival ( ). Age at the time of surgery had no impact on the incidence of postoperative complication and inpatient mortality. Both the univariate and multivariate analyses showed age, nodal stage, and positive resection margins as independent prognostic factors for patients undergoing surgery for oesophageal cancer. Conclusions. Advanced age is associated with poor outcome following oesophageal resection. However, the optimisation of both preoperative and postoperative care can significantly improve outcomes. The decision of operative management should be individualised. Age should be considered as one of the factors in surgical resection of oesophageal cancer in the elderly patients. 1. Introduction The oesophageal cancer is the eighth most common cancer worldwide, with 481,000 new cancers estimated in 2008 and the sixth most common cause of cancer death [1]. In the UK, annually there are approximately 7,800 new cases diagnosed and 7,000 deaths which result from oesophageal cancer [2]. It is associated with poor five-year survival rates of 10 to 20%. Over 80% of patients suffering from the disease are more than 60 years of age [2]. Thus, most patients who undergo treatment for oesophageal cancer fall into an older age group [3]. Because of longer life expectancy, self-awareness, availability of modern diagnostic modalities, advancement in treatment options, and modern surgical practice, more patients are being diagnosed and referred for surgical management. Treatment is based on initial staging of the oesophageal cancer. In the UK for both common histological subtypes of oesophageal cancer (adenocarcinoma and squamous cell carcinoma), if a patient is considered fit for resection, they will also be considered for perioperative chemotherapy (OEO2 [4], MAGIC [5]). In the UK a preoperative course of radiotherapy is not given routinely. Advanced
%U http://www.hindawi.com/journals/isrn.surgery/2013/609252/