A Definition of the Elderly in Esophagectomy

Shunji Mizobuchi, Hoichi Kato, Yuji Tachimori, Akihisa Umemura, Hirohumi Morita, Hiroshi Watanabe

Department of Surgery, National Cancer Center Hospital

To define the age of the elderly for surgery of esophageal carcinoma, a consecutive series of 517 patients who underwent esophagectomy by right thoracotomy and laparotomy from 1983 through 1992 was analyzed. They were classified into seven age groups (group I: 46 patients under 50 years; group II: 66 patients, 50 to 54 years; group III: 87 patients, 55 to 59 years; group IV: 107 patients, 60 to 64 years; group V: 90 patients, 65 to 69 years; group VI: 65 patients, 70 to 74 years, and group VII: 56 patients aged 75 years or older), in order to compare the pre- and postoperative function of vital organs and the incidence of complications and operative death. Postoperative periodic change in PaO₂ and the serum creatinine level significantly deteriorated in groups VI and VII. Postoperative pneumonia and delirium frequently occurred in group VII, and the rates of pneumonia and delirium were 28.6% (16/56) and 30.4% (17/56), respectively, significantly higher than those in other groups. The operative mortality for group VII was 17.9% (10/56), significantly higher than that for the groups under 70 years of age. The mortality for group VI was 12.3% (8/65). There was no significant difference in mortality in comparison with the groups under 70 years of age. We should manage patients aged over 75 years as the elderly in surgical treatment for esophageal carcinoma.

Key words
esophageal cancer in the elderly, surgery, postoperative pneumonia, postoperative delirium, postoperative atrial fibrillation

Reprint requests
Shunji Mizobuchi Department of Surgery, Naitonal Cancer Center Hospital
1-1 Tsukiji 5-chome, Chuo-ku, Tokyo, 104 JAPAN

Accepted
June 8, 1994

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