The Limit of Improvement of Surgical Results by Extended Lymphadenectomy for Aged Patients with Thoracic Esophageal Cancer -Availability of Extended upper Mediastinal Lymphadenectomy-

Reiki Eguchi, Masaho Oota, Hiroko Ide, Tsutomu Nakamura, Tetsuya Kikuchi, Keiji Tanigawa, Fujio Hanyu, Akiyoshi Yamada*

Department of Surgery and Radiology*, Institute of Gastroenterology, Tokyo Women's Medical College

Between January 1985 and Jun 1995, 924 patients with thoracic esophageal cancer were treated in our institute and 128 (13.9%) were 75 years old or above. The resection rate for patients 75 years or older (59%) was lower than that of patients below 75 years old (79%) (p<0.0001) . The incidence of preoperative imapriment of other organs in patients 75 years old or above (19%) was higher than that of patients below 75 years old (9%) (p<0.05). In this report, to evaluate the availability of extended upper mediastinal lymphadenactomy for aged patients with thoracic esophageal cancer, 75 aged patients (defined as 75 years old or above) and 625 young patients (below 75 years old) who underwent esophagecotmy were analyzed. The incidence of postoperative complications in aged patients (74%) who underwent extended upper mediastinal lymphadencetomy was higher than that of young patients (3.4%) (p<0.05). The hospital death rates of aged and young patients who underwent extended upper mediastinal lymphadenectomy were 8.9% and 3.494 respectively. The survival curve and 5-year survival rate of young patients who underwent extended upper mediastinal lymphadenectomy (37%) were better than those of young patients with underwent standard esphagectomy without upper mediastinal lymphadenectomy (28%) (o<0.05) . In aged patients, however, there were no differences in the survival curve or the 5-year survival rate. Thus, it was thought that for aged patietns extended upper mediastinal lymphadenectomy was not be indicated.

Key words
aged patients, thoracic esophageal cancer, extended upper mediastinal lymphadenectomy

Reprint requests
Reiki Eguchi Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawada-cho, Sinjuku-ku, Tokyo, 162 JAPAN

Accepted
June 12, 1996

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