High Age Increases the Risk of Complications and Reduces Survival Following Esophagectomy for Adenocarcinoma
Journal of Surgery
Volume 6, Issue 1, February 2018, Pages: 1-7
Received: Nov. 8, 2017;
Accepted: Nov. 16, 2017;
Published: Dec. 14, 2017
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Daniel Willy Kjaer, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
Kaare Terp Fjerderholt, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
Jakob Kirkegaard, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
Cecilie Okholm, Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
Michael Patrick Achiam, Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
Lars Bo Svendsen, Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
Frank Viborg Mortensen, Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
Introduction: The aim of the present study was to investigate the impact of high age and comorbidities in relation to postoperative complications, mortality, and long-term survival in patients undergoing surgery for adenocarcinoma of the esophagus and gastro-esophageal junction (GEJ). Methods: A cohort study of 557 patients operated for adenocarcinoma of the esophagus and GEJ. Data were collected from a prospectively maintained database, the Danish National Patient Registry, and medical records. Univariate and multivariate statistical models were used to analyze data after stratification for possible confounders. Results: The incidence of postoperative complications increased in patients aged ≥ 75 years compared with younger patients (OR: 1.57; 95% CI: 0.93-2.62) although not significant. However, testing for trend revealed a linear increase with age for severe complications (p=0.005). Age ≥ 75 years was also associated with increased 90-day but not 30-day mortality (HR: 5.05; 95% CI: 1.70-14.94 and HR: 3.47; 95% CI: 0.61-19.72 respectively). Overall survival decreased with increasing age (p=0.036). Conclusion: We found high age as an independent risk factor for death within 90 days but not 30 days after surgery for adenocarcinoma of the esophagus and GEJ. The presence of co-morbidity seemed to increase the risk for postoperative complications.
Daniel Willy Kjaer,
Kaare Terp Fjerderholt,
Michael Patrick Achiam,
Lars Bo Svendsen,
Frank Viborg Mortensen,
High Age Increases the Risk of Complications and Reduces Survival Following Esophagectomy for Adenocarcinoma, Journal of Surgery.
Vol. 6, No. 1,
2018, pp. 1-7.
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