高龄胸段食管癌患者食管外科治疗进展。
Advances in esophageal surgery in elderly patients with thoracic esophageal cancer.
机构信息
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
Anticancer Res. 2013 Apr;33(4):1641-7.
AIM
To justify esophagectomy for elderly patients.
PATIENTS AND METHODS
A total of 1,002 patients with thoracic esophageal cancer who underwent esophagectomy were divided into three groups: I (≤ 74 years old, n=898); II (75-79 years, n=81); and III (≥ 80 years, n=23). Historical changes were compared between the first surgical period (1964-1989) and the second period (1990-2011).
RESULTS
The morbidity rates were 40%, 41% and 26% in the respective groups. Pulmonary complications decreased historically in groups II and III (36% to 15% and 43% to 0%, respectively). The mortality was higher in the older groups (4.8%, 8.6% and 13.0%, respectively); however, there was a marked historical decrease in groups II (18.2% to 5.1%) and III (28.6% to 6.3%). The 5-year survival improved from 5% to 35% in group II and from 0% to 17% in group III.
CONCLUSION
The outcomes of esophagectomy for elderly patients have markedly improved, with acceptable mortality even in octogenarians.
目的
证明老年患者行食管癌切除术的合理性。
患者和方法
共有 1002 例行食管癌切除术的胸段食管癌症患者被分为三组：I 组（≤74 岁，n=898）；II 组（75-79 岁，n=81）；III 组（≥80 岁，n=23）。比较了第一个手术期（1964-1989 年）和第二个手术期（1990-2011 年）之间的历史变化。
结果
各组的发病率分别为 40%、41%和 26%。肺并发症在 II 组和 III 组中呈历史下降趋势（36%降至 15%，43%降至 0%）。年龄较大的组死亡率较高（4.8%、8.6%和 13.0%）；然而，II 组（18.2%降至 5.1%）和 III 组（28.6%降至 6.3%）的死亡率明显下降。II 组的 5 年生存率从 5%提高到 35%，III 组从 0%提高到 17%。
结论
老年患者食管癌切除术的结果明显改善，即使是 80 岁以上的患者，死亡率也可接受。
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