Perioperative and Long-Term Outcomes of Surgery in Patients Aged 80 Years or Older with Esophageal or Esophagogastric Junction Cancer: A Propensity Score–Matched Analysis
- 1Department of Upper Gastrointestinal Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsugagun, Tochigi 321-0293, Japan
- 2Department of Surgery, University of Miyazaki Faculty of Medicine, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
Abstract
Background/Objectives: With population aging, determining appropriate surgical indications for patients aged ≥80 years with esophageal or esophagogastric junction cancer has become increasingly important. This study compared perioperative and long-term outcomes between surgically treated patients aged ≥80 years and those aged <80 years. Methods: Patients who underwent surgery for esophageal or esophagogastric junction cancer between April 2009 and April 2026 were retrospectively analyzed. Propensity score matching was performed using sex, American Society of Anesthesiologists physical status, tumor location, histological type, clinical stage, surgical procedure, and neoadjuvant chemotherapy. After matching, 40 patients were included in each group. Perioperative outcomes, postoperative complications, overall survival (OS), and disease-specific survival (DSS) were compared. Results: Operative time, blood loss, and postoperative hospital stay did not differ significantly between the groups. Patients aged ≥80 years had fewer dissected lymph nodes (26.0 vs. 48.5, p = 0.003) and a lower incidence of Clavien–Dindo grade ≥IIIa complications (17.5% vs. 40.0%, p = 0.047). The incidences of pneumonia, recurrent laryngeal nerve palsy, and anastomotic leakage did not differ significantly. The 5-year OS was lower in patients aged ≥80 years (32.9% vs. 55.3%, p = 0.006; HR, 2.31; 95% CI, 1.24–4.28), whereas 5-year DSS did not differ significantly (55.4% vs. 69.0%, p = 0.122; HR, 1.86; 95% CI, 0.84–4.12). Conclusions: Surgery may be feasible in carefully selected patients aged ≥80 years. These findings do not establish a survival advantage over non-surgical treatment. Surgical eligibility should be based on overall condition, oncological factors, and anticipated surgical invasiveness rather than chronological age alone.
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BibTeX
@article{ochiai2026perioperative,
title = {{Perioperative and Long-Term Outcomes of Surgery in Patients Aged 80 Years or Older with Esophageal or Esophagogastric Junction Cancer: A Propensity Score–Matched Analysis}},
author = {Takahiro Ochiai and Masanobu Nakajima and Masatoshi Nakagawa and Junki Fujita and Minori Mise and Yasunori Maeda and Masaki Yoshimatsu and Eri Amagai and Shinji Morita and Kazuyuki Kojima},
journal = {Cancers},
year = {2026},
month = nov,
doi = {10.3390/cancers18213574},
url = {https://www.mdpi.com/2072-6694/18/21/3574},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Perioperative and Long-Term Outcomes of Surgery in Patients Aged 80 Years or Older with Esophageal or Esophagogastric Junction Cancer: A Propensity Score–Matched Analysis
AU - Takahiro Ochiai
AU - Masanobu Nakajima
AU - Masatoshi Nakagawa
AU - Junki Fujita
AU - Minori Mise
AU - Yasunori Maeda
AU - Masaki Yoshimatsu
AU - Eri Amagai
AU - Shinji Morita
AU - Kazuyuki Kojima
PY - 2026
DA - 2026/11/06
JO - Cancers
DO - 10.3390/cancers18213574
UR - https://www.mdpi.com/2072-6694/18/21/3574
AB - Background/Objectives: With population aging, determining appropriate surgical indications for patients aged ≥80 years with esophageal or esophagogastric junction cancer has become increasingly important. This study compared perioperative and long-term outcomes between surgically treated patients aged ≥80 years and those aged <80 years. Methods: Patients who underwent surgery for esophageal or esophagogastric junction cancer between April 2009 and April 2026 were retrospectively analyzed. Propensity score matching was performed using sex, American Society of Anesthesiologists physical status, tumor location, histological type, clinical stage, surgical procedure, and neoadjuvant chemotherapy. After matching, 40 patients were included in each group. Perioperative outcomes, postoperative complications, overall survival (OS), and disease-specific survival (DSS) were compared. Results: Operative time, blood loss, and postoperative hospital stay did not differ significantly between the groups. Patients aged ≥80 years had fewer dissected lymph nodes (26.0 vs. 48.5, p = 0.003) and a lower incidence of Clavien–Dindo grade ≥IIIa complications (17.5% vs. 40.0%, p = 0.047). The incidences of pneumonia, recurrent laryngeal nerve palsy, and anastomotic leakage did not differ significantly. The 5-year OS was lower in patients aged ≥80 years (32.9% vs. 55.3%, p = 0.006; HR, 2.31; 95% CI, 1.24–4.28), whereas 5-year DSS did not differ significantly (55.4% vs. 69.0%, p = 0.122; HR, 1.86; 95% CI, 0.84–4.12). Conclusions: Surgery may be feasible in carefully selected patients aged ≥80 years. These findings do not establish a survival advantage over non-surgical treatment. Surgical eligibility should be based on overall condition, oncological factors, and anticipated surgical invasiveness rather than chronological age alone.
SN - 2072-6694
ER -