The Impact of Age on the Post-operative Outcomes in Patients Undergoing Resection for Oesophageal and Gastric Cancer

被引:3
作者
Law, Cameron [1 ,2 ]
Bhimani, Nazim [1 ,3 ]
Mitchell, David [1 ]
Yu, Mia Yue [1 ]
Chan, Priscilla [1 ]
Leibman, Steven [1 ,2 ]
Smith, Garett [1 ,2 ]
机构
[1] Royal North Shore Hosp, Upper Gastrointestinal Unit, Clin Adm Off ASB 8A, Reserve Rd, St Leonards, NSW 2065, Australia
[2] Univ Sydney, Northern Clin Sch, Sydney, NSW, Australia
[3] Univ Sydney, Fac Med & Hlth, Sydney, NSW, Australia
关键词
ELDERLY-PATIENTS; BETA-BLOCKADE; RISK-FACTORS; COMPLICATIONS; NEOADJUVANT; MORTALITY; SURGERY; FRAILTY; FEASIBILITY; ASSOCIATION;
D O I
10.1007/s00268-023-07223-x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Within our ageing population, there is an increasing number of elderly patients presenting with oesophagogastric cancer. Resection remains the mainstay of curative treatment however it has substantial morbidity. The aim of this study was to assess whether age was an independent predictor of resection related complications in our unit.Methods A retrospective cohort study of prospectively collated data from 2002 to 2020 of patients undergoing resection for oesophageal and gastric cancers was analysed. Patients aged over 75 and 75 and under were compared for peri-operative morbidity (via the Clavien-Dindo classification), length of stay (LOS), unplanned readmission, 30- and 90-day mortality, and use of neoadjuvant therapy.Results Data for 466 consecutive patients undergoing oesophagogastric resection (277 oesophagectomy and 189 gastrectomy) were available for analysis. 22% of patients were aged over 75 (14% (39/277) of the oesophagectomy cohort, 34% (65/189) of the gastrectomy cohort). Oesophagectomy patients over 75 were more likely to develop post-operative complications, particularly cardiac or thromboembolic, (69.2%) than those in the younger cohort (50.4%, p = 0.029). There was no difference in complication rates between the younger and older patients undergoing gastrectomy (29.0% vs. 33.9% p = 0.495). The 30- and 90-day mortality rates were 1.4% (n = 4) and 2.5% (n = 7), respectively, for the oesophagectomy cohort and 1.1% (n = 2) and 1.6% (n = 3) for the gastrectomy cohort, with no difference between age groups.Conclusion In this series, we found that patients over the age of 75 were able to undergo oesophageal and gastric resection with curative intent with acceptable post-operative morbidity and mortality.
引用
收藏
页码:3270 / 3280
页数:11
相关论文
共 35 条
  • [1] AioHa W., 2021, CANC DATA AUSTR
  • [2] Outcomes after esophagectomy: A ten-year prospective cohort
    Bailey, SH
    Bull, DA
    Harpole, DH
    Rentz, JJ
    Neumayer, LA
    Pappas, TN
    Daley, J
    Henderson, WG
    Krasnicka, B
    Khuri, SF
    [J]. ANNALS OF THORACIC SURGERY, 2003, 75 (01) : 217 - 222
  • [3] Frailty assessment: from clinical to radiological tools
    Bentov, Itay
    Kaplan, Stephen J.
    Pham, Tam N.
    Reed, May J.
    [J]. BRITISH JOURNAL OF ANAESTHESIA, 2019, 123 (01) : 37 - 50
  • [4] Neo-adjuvant chemo(radio) therapy in gastric cancer: Current status and future perspectives
    Biondi, Alberto
    Lirosi, Maria C.
    D'Ugo, Domenico
    Fico, Valeria
    Ricci, Riccardo
    Santullo, Francesco
    Rizzuto, Antonia
    Cananzi, Ferdinando C. M.
    Persiani, Roberto
    [J]. WORLD JOURNAL OF GASTROINTESTINAL ONCOLOGY, 2015, 7 (12) : 389 - 400
  • [5] Meta-analysis of secure randomised controlled trials of β-blockade to prevent perioperative death in non-cardiac surgery
    Bouri, Sonia
    Shun-Shin, Matthew James
    Cole, Graham D.
    Mayet, Jamil
    Francis, Darrel P.
    [J]. HEART, 2014, 100 (06) : 456 - 464
  • [6] Venous thromboembolism in cancer patients receiving neoadjuvant chemotherapy: a systematic review and meta-analysis
    Di Nisio, M.
    Candeloro, M.
    Rutjes, A. W. S.
    Porreca, E.
    [J]. JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 2018, 16 (07) : 1336 - 1346
  • [7] Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey
    Dindo, D
    Demartines, N
    Clavien, PA
    [J]. ANNALS OF SURGERY, 2004, 240 (02) : 205 - 213
  • [8] Bisoprolol and Fluvastatin for the Reduction of Perioperative Cardiac Mortality and Myocardial Infarction in Intermediate-Risk Patients Undergoing Noncardiovascular Surgery A Randomized Controlled Trial (DECREASE-IV)
    Dunkelgrun, Martin
    Boersma, Eric
    Schouten, Olaf
    Koopman-van Gemert, Ankie W. M. M.
    van Poorten, Frans
    Bax, Jeroen J.
    Thomson, Ian R.
    Poldermans, Don
    [J]. ANNALS OF SURGERY, 2009, 249 (06) : 921 - 926
  • [9] DO ELDERLY PATIENTS EXPERIENCE INCREASED PERIOPERATIVE OR POSTOPERATIVE MORBIDITY OR MORTALITY WHEN GIVEN NEOADJUVANT CHEMORADIATION BEFORE ESOPHAGECTOMY?
    Fogh, Shannon E.
    Yu, Anthony
    Kubicek, Gregory J.
    Scott, Walter
    Mitchell, Edith
    Rosato, Ernest L.
    Berger, Adam C.
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2011, 80 (05): : 1372 - 1376
  • [10] Prevalence of frailty and its association with mortality in general surgery
    Hewitt, Jonathan
    Moug, Susan J.
    Middleton, Maeve
    Chakrabarti, Mohua
    Stechman, Micheal J.
    McCarthy, Kathryn
    [J]. AMERICAN JOURNAL OF SURGERY, 2015, 209 (02) : 254 - 259