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Purpose <p>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.</p> Methods <p>This study included 110 elderly patients (aged ≥ 75&#xa0;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&#xa0;years.</p> Results <p>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).</p> Conclusions <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2025年2月7日

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  • 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

摘要

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.