Risk factors of poor long-term outcomes in elderly patients with esophageal squamous cell carcinoma after minimally invasive esophagectomy.

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-05-01 Epub Date: 2025-02-07 DOI:10.1007/s00595-024-02947-2

Yasufumi Koterazawa, Hironobu Goto, Tatsuya Kaneko, Yuki Azumi, Ryuichiro Sawada, Taro Ikeda, Hitoshi Harada, Naoki Urakawa, Hiroshi Hasegawa, Shingo Kanaji, Kimihiro Yamashita, Takeru Matsuda, Taro Oshikiri, Yoshihiro Kakeji

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引用次数: 0

Abstract

Purpose: Elderly patients with esophageal squamous cell carcinoma (ESCC) have more comorbidities than young patients do. Elderly smokers have a high mortality rate owing to physical dysfunction. This study aimed to identify risk factors for long-term outcomes after minimally invasive esophagectomy (MIE) in elderly patients with ESCC.

Methods: This study included 110 elderly patients (aged ≥ 75 years) with ESCC who underwent MIE at Kobe University Hospital. Multivariate Cox proportional hazards regression analyses were performed to identify risk factors, including the geriatric nutritional risk index (GNRI), Charlson comorbidity index, and elderly smoker status, defined as smoking at the age of 70 years.

Results: Multivariate analysis identified that elderly smokers, cT or cN status (≥ cT2 or cN-positive), and GNRI (≤ 92) were independent prognostic factors for overall survival (p = 0.026, 0.019, and 0.038, respectively). For patients with ≥ cT2 or cN-positive ESCC, elderly smokers or patients with GNRI (≤ 92) have significantly worse survival (p = 0.038). Elderly smokers were at risk of death from other diseases five years postoperatively (p = 0.016).

Conclusions: Elderly smokers, cT2 or cN positivity, and low GNRI were risk factors for poor survival. Furthermore, for patients with ≥ cT2 or cN-positive ESCC, these risk factors were associated with poor survival.

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老年食管鳞状细胞癌微创食管切除术后远期预后不良的危险因素

目的：老年食管鳞状细胞癌（ESCC）患者的合并症多于年轻患者。由于身体功能障碍，老年吸烟者的死亡率很高。本研究旨在确定老年ESCC患者微创食管切除术（MIE）后长期预后的危险因素。方法：在神户大学医院接受MIE治疗的ESCC老年患者110例（年龄≥75岁）。采用多变量Cox比例风险回归分析来确定危险因素，包括老年营养风险指数（GNRI）、Charlson合并症指数和老年吸烟者状态（定义为70岁以上吸烟）。结果：多因素分析发现，老年吸烟者、cT或cN状态（≥cT2或cN阳性）和GNRI（≤92）是总生存的独立预后因素（p分别= 0.026、0.019和0.038）。对于≥cT2或cn阳性的ESCC患者，老年吸烟者或GNRI（≤92）患者的生存率明显较差（p = 0.038）。老年吸烟者术后5年死于其他疾病的风险较高（p = 0.016）。结论：老年吸烟者、cT2或cN阳性以及低GNRI是不良生存率的危险因素。此外，对于cT2≥或cn阳性的ESCC患者，这些危险因素与较差的生存率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.