Treatment of Patients with Esophageal Carcinoma Above and 80 Years-old

Hajime Yonekawa, Shingo Shima*, Yutaka Yoshizumi*, Takashi Bessho, Susumu Tanaka*

Department of Surgery, National Ohkura Hospital
*Department of Surgery II, National-Defense Medical College

The treatment of 19 patients of more than 80 years old with esophageal carcinoma, who had admitted to our two hospitals from 1980 to 1990, was analyzed.1) Eighteen of the 19 patients had some impairment in circulatory, respiratory, liver, or renal function tests, with abnormalities of the former two being found in about half of the patients. 2) The prognosis of five patients who received radiotherapy alone was poor; two patients survived for 6 month, however, no patient survived over 1 year. 3) Twelve patients underwent surgical resection of the esophagus through right or left thoracotomy followed by single stage reconstruction of the alimentary tract. The hospital death rate of these patients was 41.7%, with a 1-year survival rate of 33.3%. 4) The most common cause of hospital death in surgical patients was postoperative pulmonary insufficiency, with the half being a part of multiple organ failure which seemed to be caused by inadequate circulation of the stomach or jejunum used for the reconstruction. 5) The prognosis was extremely poor if the patient had functional impairement in two or more organs, or underwent noncurative resection including the case of recurrence after radiotherapy. Therefore, surgery should not be attemped under these conditions.

Key words
carcinoma of the esophagus, aged patients (80 years-old), esophagectomy

Reprint requests
Hajime Yonekawa Department of Surgery, National Ohkura Hospital
2-10-1 Ohkura, Setagaya-ku, Tokyo, 177 JAPAN

Accepted
April 13, 1994

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