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P-OGC96 Oesophagectomy with Enhanced Recovery for Adenocarcinoma in the Elderly


 
 
 The incidence of oesophageal adenocarcinoma is rising rapidly in high-income countries. Combined with an ageing population, it is expected that the need for treatment, including surgery, will increase in the next decade. Oesophagectomy in patients ≥70 years old has been associated with a higher risk of complications. The aim of our study is to compare the outcomes of patients ≥70 vs < 70 years old, who underwent oesophagectomy for adenocarcinoma with an enhanced recovery (ERAS) protocol.
 
 
 
 A single-centre retrospective study was performed. Eligible cases were divided into the <70 and the ≥70 groups for comparison of baseline variables, postoperative outcomes, and overall survival.
 
 
 
 From January 2014 through September 2020, oesophagectomy with ERAS was performed for 230 patients with adenocarcinoma. Most (85%) patients were male. The median age was 70 years. The overall 90-day complication rate was 69.6%. The anastomotic leak rate was 16.1%. The 30- and 90-day mortality rates were 0 and 3.0% respectively. Median length of stay (LoS) was 7.0 days (IQR=5.0) and the readmission rate was 18.7%. The overall complication rate was higher in the ≥70 vs the <70 group (75.6% vs 63.1%; p = 0.038). There was no significant difference in major complications, anastomotic leakage, mortality, LoS, or readmission (p > 0.05) between the groups. Estimated mean survival was lower in the ≥70 vs the <70 group (45.6 vs 57.9 months; p = 0.045).
 
 
 
 Elderly patients with oesophageal adenocarcinoma can undergo oesophagectomy with ERAS, achieving similar postoperative outcomes to younger patients. In an era of an ageing population with an increasing disease burden, these findings are encouraging.
