Case Western Reserve University School of Medicine, Cleveland, Ohio.
Department of Surgery, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio.
J Surg Oncol. 2020 May;121(6):1015-1021. doi: 10.1002/jso.25866. Epub 2020 Feb 23.
Current data are conflicting as to whether the outcomes of octogenarians undergoing resection for esophagogastric adenocarcinoma are comparable to younger patients. This study aims to compare perioperative outcomes and survival of patients ≥80 years old with younger patients undergoing curative resection for esophagogastric adenocarcinoma.
Retrospective data were collected on 190 patients who underwent resection with curative intent for adenocarcinomas found in the stomach and esophagogastric junction from 2004 to 2015 at a single institution.
Of the 190 patients, 34 (18%) were ≥80 years old. Octogenarians were more likely to have chronic kidney disease (CKD) and were less likely to have received neoadjuvant chemotherapy. Pathologic features were similar between groups. Octogenarians' tumors were more likely to be located in the gastric body as compared to the esophagogastric junction in younger patients. Although the length of stay was comparable, octogenarians were significantly less likely to be discharged home (P < .01). Both groups had a single death during the index admission. Incidence and severity of 90 days postoperative complications were not significantly different between groups. There was no difference in 30-day, 90-day, 1-year, or median survival.
Perioperative outcomes and survival of octogenarians undergoing curative resection for esophagogastric cancer are comparable to younger patients at our institution.
目前对于 80 岁以上患者接受胃食管腺癌切除术的结果是否与年轻患者相当仍存在争议。本研究旨在比较 80 岁以上患者与接受根治性切除术的年轻患者的围手术期结局和生存情况。
回顾性收集了 2004 年至 2015 年在一家医疗机构接受胃和食管胃交界腺癌根治性切除术的 190 例患者的数据。
在 190 例患者中，有 34 例（18%）年龄≥80 岁。80 岁以上患者更有可能患有慢性肾脏病（CKD），且不太可能接受新辅助化疗。两组的病理特征相似。与年轻患者相比，80 岁以上患者的肿瘤更可能位于胃体而不是食管胃交界处。虽然住院时间相似，但 80 岁以上患者出院回家的可能性明显较小（P<.01）。两组在索引住院期间均有 1 例死亡。两组术后 90 天并发症的发生率和严重程度无显著差异。两组在 30 天、90 天、1 年或中位生存时间上均无差异。
在我们的机构中，接受胃食管癌症根治性切除术的 80 岁以上患者的围手术期结局和生存情况与年轻患者相当。
