Advances in Esophageal Surgery in Elderly Patients with Thoracic Esophageal Cancer

Aim: To justify esophagectomy for elderly patients. Patients and Methods: A total of 1,002 patients with thoracic esophageal cancer who underwent esophagectomy were divided into three groups: I (<= 74 years old, n=898); II (75-79 years, n=81); and III (>= 80 years, n=23). Historical changes were compared between the first surgical period (1964-1989) and the second period (1990-2011). Results: The morbidity rates were 40%, 41% and 26% in the respective groups. Pulmonary complications decreased historically in groups II and III (36% to 15% and 43% to 0%, respectively). The mortality was higher in the older groups (4.8%, 8.6% and 13.0%, respectively); however, there was a marked historical decrease in groups II (18.2% to 5.1%) and III (28.6% to 6.3%). The 5-year survival improved from 5% to 35% in group II and from 0% to 17% in group III. Conclusion: The outcomes of esophagectomy for elderly patients have markedly improved, with acceptable mortality even in octogenarians.