Li Kexun, Lu Simiao, Li Changding, Mao Jie, Zhang Huan, Wang Kangning, Liu Guangyuan, Huang Yunchao, Han Yongtao, Leng Xuefeng, Peng Lin
Department of Thoracic Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu. No. 55, Section 4, South Renmin Road, Chengdu, 610041, Sichuan, China.
Department of Thoracic Surgery I, Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Kunming, China.
Discov Oncol. 2025 Jun 23;16(1):1182. doi: 10.1007/s12672-025-03009-w.
Esophageal squamous cell carcinoma (ESCC) is prevalent in East Asia, with elderly patients facing unique postoperative challenges. This study examines the impact of seasonal variations on postoperative complications and survival in elderly patients undergoing esophagectomy for ESCC.
This retrospective cohort study was conducted using data from the Sichuan Cancer Hospital & Institute Esophageal Cancer Case Management Database. Elderly patients (≥ 70 years) with thoracic ESCC who underwent esophagectomy between May 2016 and August 2021 were included. Patients were stratified into four seasonal groups: Winter (December-February), Spring (March-May), Summer (June-August), and Autumn (September-November). Primary outcomes included overall survival (OS), disease-free survival (DFS). Secondary outcomes assessed postoperative complications using the Clavien-Dindo classification.
A total of 469 elderly ESCC patients were included. The median overall survival was 51.6 months, with no significant differences in OS or DFS across the four seasonal groups. Restricted Mean Survival Time (RMST) and Restricted Mean Disease-Free Survival Time (RMDFST) analyses also showed no significant seasonal variations. The Summer group had a significantly higher incidence of hydrothorax compared to other groups (p < 0.05).
Seasonal variations influence specific short-term postoperative complications but do not significantly impact long-term survival in elderly ESCC patients undergoing esophagectomy.
食管鳞状细胞癌（ESCC）在东亚地区较为普遍，老年患者术后面临独特挑战。本研究探讨了季节变化对接受ESCC食管切除术的老年患者术后并发症和生存的影响。
本回顾性队列研究使用了四川省肿瘤医院&研究所食管癌病例管理数据库的数据。纳入2016年5月至2021年8月期间接受食管切除术的老年胸段ESCC患者（≥70岁）。患者被分为四个季节组：冬季（12月至2月）、春季（3月至5月）、夏季（6月至8月）和秋季（9月至11月）。主要结局包括总生存期（OS）、无病生存期（DFS）。次要结局使用Clavien-Dindo分类评估术后并发症。
共纳入469例老年ESCC患者。中位总生存期为51.6个月，四个季节组的OS或DFS无显著差异。受限平均生存时间（RMST）和受限平均无病生存时间（RMDFST）分析也显示无显著季节差异。与其他组相比，夏季组胸腔积液的发生率显著更高（p<0.05）。
季节变化影响特定的术后短期并发症，但对接受食管切除术的老年ESCC患者的长期生存无显著影响。
