Ruol Alberto, Portale Giuseppe, Castoro Carlo, Merigliano Stefano, Cavallin Francesco, Battaglia Giorgio, Michieletto Silvia, Ancona Ermanno
Department of Surgery and Organ Transplant, Clinica Chirurgica III, University of Padova School of Medicine, Padova, Italy.
Eur J Cardiothorac Surg. 2007 Sep;32(3):445-8. doi: 10.1016/j.ejcts.2007.06.014. Epub 2007 Jul 23.
Important advances in the management of cancer of the esophagus and esophagogastric junction have occurred in the last decades, making treatment possible even in elderly patients. Unfortunately there is little information on management of esophageal cancer in octogenarian patients. The aim of this study was to evaluate the treatment results of esophageal and esophagogastric junction cancer in a single institution over a 14-year period in patients>or=80 years of age.
Clinicopathological characteristics and management strategies were studied in patients>or=80 years old with cancer of the esophagus or esophagogastric junction, referred to our department and treated between 1992 and 2005.
There were 62 patients>or=80 years: 12 underwent surgical resection and 50 were not resected. There were no perioperative deaths. The morbidity rate was 33%. Most non-resected patients had an endoscopic prosthesis. The median survival for the overall group was 5.4 months: 14.6 and 5.1 in resected and non-resected patients, respectively.
Even in octogenarian patients--with limited comorbidities and fit for surgery--esophagectomy may be regarded as a valid treatment option. Unfortunately this remains possible only in a small minority of 80-90-year old patients. In the remainder, endoscopic treatments--namely prosthesis placements, with chemoradiotherapy when possible--are the alternatives.
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