RISK FACTORS OF POOR LONG-TERM OUTCOMES IN ELDERLY PATIENTS WITH ESOPHAGEAL SQUAMOUS CELL CARCINOMA AFTER MINIMALLY INVASIVE ESOPHAGECTOMY miyamo9511@gmail.com

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RISK FACTORS OF POOR LONG-TERM OUTCOMES IN ELDERLY PATIENTS WITH ESOPHAGEAL SQUAMOUS CELL CARCINOMA AFTER MINIMALLY INVASIVE ESOPHAGECTOMY

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Japan

Oral or Poster

As the global population ages, there is a concurrent increase in the number of elderly patients diagnosed with esophageal squamous cell carcinoma (ESCC) and undergoing esophagectomy. Elderly patients have more comorbidities and malnutrition than young patients, it leads poor prognosis. Elderly smokers have high mortality because of their physical dysfunction and smoking related disease according to long duration of smoking. This study aimed to identify the risk factors for long-term outcomes after minimally invasive esophagectomy (MIE) in elderly patients with ESCC and assess the prognosis such patients with risk factors.

This study comprised 110 elderly patients (≥75 years) with ESCC who underwent MIE at Kobe University Hospital. Multivariate Cox proportional hazards regression analyses were performed to identify prognostic factors, including Geriatric nutritional risk index (GNRI), Charlson comorbidity index, elderly smoker status. We defined elderly smoker as patients smokes at the age of 70 years.

Multivariate analysis identified that elderly smoker, cT or cN status (cT2 ≤ or cN positive) and GNRI (≤92) were independent prognostic factors for overall survivals (p=0.026, 0.019, and 0.038, respectively). For the patients with cT2 ≤ or cN positive ESCC, elderly smoker with GNRI (≤92) have significantly worse survival (p=0.013). Elderly smoker was at a risk of death from other diseases 5 years postoperatively (p=0.016).

Elderly smoker, cT2 ≤ or cN positive, and low GNRI were risk factors of poor survival. Furthermore, elderly ESCC patients with all these risk factors were associated with very poor survival outcome.