Short- and long-term outcomes of minimally invasive esophagectomy in elderly patients with esophageal squamous cell carcinoma.

PURPOSE: In recent years, there has been an increase in the number of elderly patients undergoing surgery for esophageal squamous cell carcinoma (ESCC). However, there are few studies on short- and long-term outcomes of minimally invasive esophagectomy (MIE) in such patients. The purpose of this study was to report both short- and long-term outcomes of MIE in elderly patients with ESCC.

METHODS: A total of 273 patients with ESCC underwent MIE at our hospital from January 2010 to December 2016. Patients were divided into elderly (≥70 years) and nonelderly (<70 years) groups based on age at the time of surgery. Groups were compared with regard to general preoperative data, intraoperative data, postoperative 30-day complications and their severity, pathological result, recurrence, overall survival (OS), and disease-free survival (DFS) rates.

RESULTS: The elderly group was characterized by higher Charlson Comorbidity Index >2 and American Society of Anesthesiologists (ASA) grade. Comparisons of other general preoperative data showed no significant differences. In addition, there were no significant differences in short-term outcomes except for postoperative 30-day complication rate. Although 30-day postoperative complication rate was higher in the elderly group compared with the nonelderly group, the incidence of major complications was similar between groups. Cancer recurrence, 5-year OS, and 5-year DFS rates also were similar between groups.

CONCLUSION: Although elderly patients with ESCC had higher Charlson Comorbidity Index and ASA grade, they could achieve short- and long-term outcomes of MIE similar to those of nonelderly patients.