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High Age Increases the Risk of Complications and Reduces Survival Following Esophagectomy for Adenocarcinoma

Received: 8 November 2017     Accepted: 16 November 2017     Published: 14 December 2017
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Abstract

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.

Published in Journal of Surgery (Volume 6, Issue 1)
DOI 10.11648/j.js.20180601.11
Page(s) 1-7
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Esophageal Neoplasms, Adenocarcinoma, Aged, Esophagectomy

References
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Cite This Article
  • APA Style

    Daniel Willy Kjaer, Kaare Terp Fjerderholt, Jakob Kirkegaard, Cecilie Okholm, Michael Patrick Achiam, et al. (2017). High Age Increases the Risk of Complications and Reduces Survival Following Esophagectomy for Adenocarcinoma. Journal of Surgery, 6(1), 1-7. https://doi.org/10.11648/j.js.20180601.11

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    ACS Style

    Daniel Willy Kjaer; Kaare Terp Fjerderholt; Jakob Kirkegaard; Cecilie Okholm; Michael Patrick Achiam, et al. High Age Increases the Risk of Complications and Reduces Survival Following Esophagectomy for Adenocarcinoma. J. Surg. 2017, 6(1), 1-7. doi: 10.11648/j.js.20180601.11

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    AMA Style

    Daniel Willy Kjaer, Kaare Terp Fjerderholt, Jakob Kirkegaard, Cecilie Okholm, Michael Patrick Achiam, et al. High Age Increases the Risk of Complications and Reduces Survival Following Esophagectomy for Adenocarcinoma. J Surg. 2017;6(1):1-7. doi: 10.11648/j.js.20180601.11

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  • @article{10.11648/j.js.20180601.11,
      author = {Daniel Willy Kjaer and Kaare Terp Fjerderholt and Jakob Kirkegaard and Cecilie Okholm and Michael Patrick Achiam and Lars Bo Svendsen and Frank Viborg Mortensen},
      title = {High Age Increases the Risk of Complications and Reduces Survival Following Esophagectomy for Adenocarcinoma},
      journal = {Journal of Surgery},
      volume = {6},
      number = {1},
      pages = {1-7},
      doi = {10.11648/j.js.20180601.11},
      url = {https://doi.org/10.11648/j.js.20180601.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20180601.11},
      abstract = {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.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - High Age Increases the Risk of Complications and Reduces Survival Following Esophagectomy for Adenocarcinoma
    AU  - Daniel Willy Kjaer
    AU  - Kaare Terp Fjerderholt
    AU  - Jakob Kirkegaard
    AU  - Cecilie Okholm
    AU  - Michael Patrick Achiam
    AU  - Lars Bo Svendsen
    AU  - Frank Viborg Mortensen
    Y1  - 2017/12/14
    PY  - 2017
    N1  - https://doi.org/10.11648/j.js.20180601.11
    DO  - 10.11648/j.js.20180601.11
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 1
    EP  - 7
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20180601.11
    AB  - 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.
    VL  - 6
    IS  - 1
    ER  - 

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Author Information
  • Department of Surgery, Aarhus University Hospital, Aarhus, Denmark

  • Department of Surgery, Aarhus University Hospital, Aarhus, Denmark

  • Department of Surgery, Aarhus University Hospital, Aarhus, Denmark

  • Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark

  • Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark

  • Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark

  • Department of Surgery, Aarhus University Hospital, Aarhus, Denmark

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