Atila EROĞLU, Atila TÜRKYILMAZ, Yener AYDIN, Betül GÜNDOĞDU

The effectiveness of transthoracic surgical treatment in elderly patients with esophageal cancer

Amaç: Bu çalışmada ileri yaş özofagus kanserli olgularda cerrahi tedavi ve sağkalım sonuçları değerlendirildi. Çalışma planı: Ocak 1998 ve Haziran 2010 tarihleri arasında ardışık 37 ileri yaşlı hastaya (24 kadın, 13 erkek, ort. yaş 74±3.7 yıl; dağılım 70-83 yıl) Ivor Lewis tipi özofajektomi uygulandı. Palyatif nedenlerle özofajektomi uygulananlar, neoadjuvant kemoterapi tedavisi uygulananlar, Ivor Lewis tipi özofajektomiye ek cerrahi işlem uygulananlar ve mide dışında başka bir rekonstrüksiyon organı kullanılan hastalar çalışmaya dahil edilmedi. Bulgular: Amerikan Ortak Kanser Komitesi (AJCC) evreleme sistemine göre, hastaların dördünün (%10.8); 13ünün (%35.2); altısının (%16.2) ve 14ünün sırası ile evre I, evre IIA, evre IIB ve evre III olduğu bulundu. On altı hastada (%43.2) ameliyat sırası, erken ve geç dönem ameliyat sonrası komplikasyonlar görüldü. Hastane mortalitesi (30 gün) %8.1 (n=3) idi. Mortalitenin primer nedenleri anastomoz kaçağı ve solunum yetmezliği idi. Ameliyat sonrası ortalama hastane yatış süresi, 14.5 gün idi. Medyan sağkalım 28.7 ay idi. Bir yıl, üç yıl ve beş yıllık sağkalım oranları sırası ile %70.3, %31.0 ve %21.4 idi. Sonuç: Bu çalışmanın sonuçları, ileri yaş özofagus kanserli seçilmiş olgularda transtorasik cerrahi tedavinin uygulanabileceğini göstermektedir.

leri yaş özofagus kanserli olgularda transtorasik cerrahi tedavinin etkinliği

Background: The aim of this study was to assess the results of surgical treatment and survival in elderly patients with esophageal carcinoma. Methods: Between January 1998 and June 2010, 37 consecutive elderly patients (24 females, 13 males, mean age 74±3.7 years; range 70 to 83 years) underwent Ivor Lewis-type esophagectomy. Patients who underwent esophagectomy for palliative reasons, those who were treated with neoadjuvant chemotherapy, those who underwent another surgical procedure together with Ivor Lewis esophagectomy, and those whose reconstruction was performed with any tissue other than that of the stomach were excluded. Results: According to American Joint Committee on Cancer (AJCC) staging, four (10.8%), 13 (35.2%), six (16.2%) and 14 (37.8%) were found to have stage I, IIA, IIB and III respectively. Perioperative, early and late postoperative complications occurred in 16 patients (43.2%). The hospital mortality rate (30-days) was 8.1% (n=3). The primary causes of mortality were anastomotic leak and respiratory failure. The mean hospital stay after the operation was 14.5 days. The median survival was 28.7 months. The one-year, three- year, and five-year survival rates of the patients were 70.3%, 31.0%, and 21.4%, respectively. Conclusion: The results of the study suggest that transthoracic surgical management may be performed in selected elderly patients with esophageal cancer.

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