Older Persons with Cancer of the Esophagus May Benefit from Surgery

Older Persons with Cancer of the Esophagus May Benefit from Surgery.

Treatment of cancer of the esophagus, the tube that connects the throat to the stomach, usually includes surgery or radiation therapy, sometimes with chemotherapy. Surgery often involves an

esophagectomy, or removal of part or all of the esophagus, to help relieve the symptoms of disease, prevent the cancer from recurring (returning), and prolong survival time. Because an esophagectomy and other aggressive surgical procedures can be associated with major complications, many doctors believe that elderly persons cannot tolerate such a procedure and therefore do not recommend this option. However, French researchers recently reported that some older persons can benefit from an esophagectomy, without an increased risk for surgical complications.

Researchers in France evaluated the outcomes of 89 persons, age 70 years or older, who underwent an esophagectomy as treatment for cancer of the esophagus. The most common type of esophageal cancer in this group was adenocarcinoma, and the surgeries were conducted using a single-incision approach. The researchers then compared their findings from these elderly persons with those from a younger group of 451 persons who also underwent an esophagectomy for cancer of the esophagus. The results showed that the rates of surgical complications (25%) and of deaths occurring after surgery (8%) in the older patients did not differ from those of the younger patients. Among elderly persons, the 1-year survival rate was 59%, the 3-year survival rate 23%, and the 5-year survival rate 13%. Survival rates did not differ between the 2 age groups.

From these observations, the researchers concluded that select elderly persons with cancer of the esophagus can undergo an esophagectomy without an increased risk for surgical complications or a related diminished survival time because of their age. Older persons who have cancer of the esophagus may wish to talk with their doctor about the risks and benefits of surgery as compared with those of other treatment options. (Annals of Thoracic Surgery, Vol 63, No 5, pp 1423-1427, 1997)

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