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

Daniel Willy Kjaer; Kaare Terp Fjerderholt; Jakob Kirkegaard; Cecilie Okholm; Michael Patrick Achiam; Lars Bo Svendsen; Frank Viborg Mortensen

doi:doi:10.11648/j.js.20180601.11

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

Daniel Willy Kjaer, Kaare Terp Fjerderholt, Jakob Kirkegaard, Cecilie Okholm, Michael Patrick Achiam, Lars Bo Svendsen, Frank Viborg Mortensen

Published in Journal of Surgery (Volume 6, Issue 1)

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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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

Daniel Willy Kjaer

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
Kaare Terp Fjerderholt

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
Jakob Kirkegaard

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
Cecilie Okholm

Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
Michael Patrick Achiam

Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
Lars Bo Svendsen

Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
Frank Viborg Mortensen

Department of Surgery, Aarhus University Hospital, Aarhus, Denmark

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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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