Chino O, Makuuchi H, Machimura T, Mizutani K, Shimada H, Kanno K, Nishi T, Tanaka H, Sasaki T, Tajima T, Mitomi T, Sugihara T
Second Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan.
Surg Today. 1997;27(1):9-16. doi: 10.1007/BF01366933.
A total of 828 patients with esophageal cancer were treated at the Second Department of Surgery of Tokai University in the 20-year period from 1975 to June 1994, including 45 patients over 80 years old. We reviewed these elderly patients to assess the optimum therapeutic approach for such individuals. In recent years, the number of elderly patients with esophageal cancer has steadily been increasing. Advanced cancer is more common among this group, but early cancer has also been detected more frequently in recent years. Of the 45 elderly patients (80%) in our series, 36 were encountered in the last 10 years. As 28.9% of the patients had multiple cancers, a careful workup was necessary preoperatively. Since most patients (88.9%) had complications and were also in a poor general condition, limited surgery was recommended in consideration of the postoperative quality of life. The indications for endoscopic mucosal resection (EMR) may be able to be extended to submucosal1 (sm1) cancer without lymph node swelling. Postoperative complications occurred in 60% of those undergoing surgical resection or esophageal bypass, although death only resulted in 1 case. The 5-year survival rate after surgical resection was 30.8%. These results therefore support the use of surgical treatment for selected elderly patients with esophageal cancer.
1975年至1994年6月的20年间，东海大学第二外科共治疗了828例食管癌患者，其中包括45例80岁以上的患者。我们对这些老年患者进行了回顾，以评估针对此类患者的最佳治疗方法。近年来，老年食管癌患者的数量一直在稳步增加。晚期癌症在该群体中更为常见，但近年来早期癌症的检出率也更高。在我们系列研究的45例老年患者中（占80%），有36例是在过去10年中遇到的。由于28.9%的患者患有多种癌症，因此术前需要进行仔细的检查。由于大多数患者（88.9%）有并发症且全身状况较差，考虑到术后生活质量，建议进行有限的手术。内镜黏膜切除术（EMR）的适应证可能能够扩展至无淋巴结肿大的黏膜下1（sm1）癌。接受手术切除或食管旁路手术的患者中，60%发生了术后并发症，不过仅1例死亡。手术切除后的5年生存率为30.8%。因此，这些结果支持对选定的老年食管癌患者采用手术治疗。
