PD08.02. Patterns in Surgical Outcomes and Survival in Elderly Patients Post Ivor-Lewis Oesophagectomy

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ID: 325684
2026
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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – long term outcomes Background Oesophagectomy remains a cornerstone of curative treatment for oesophageal cancer, yet management in elderly patients is significantly variable. This study evaluates peri-operative morbidity, mortality, and long-term survival in patients aged ≥75 years undergoing Ivor–Lewis oesophagectomy at a high-volume UK centre, with particular focus on the prognostic impact of postoperative complications. Methods A retrospective analysis was performed of a prospectively maintained database including all patients undergoing Ivor–Lewis oesophagectomy between 2012 and 2024. Patients were stratified by age (<75 vs ≥75 years). Complications were classified using Clavien–Dindo and Esophagectomy Complications Consensus Group (ECCG) definitions. Overall survival was analysed using Kaplan–Meier methods and Cox regression modelling. Results A total of 634 patients were included, of whom 138 (21.8%) were aged over 75 years, including 46 patients aged ≥80. Older patients had higher ASA scores and experienced higher overall complication rates, particularly cardiorespiratory events, with increased unplanned ICU admission and higher 90-day mortality (7.2% vs 2.2%, p<0.01). Five-year overall survival was lower in patients over 75 (31.9% vs 48.1%), with non-cancer-related mortality accounting for a significantly greater proportion of deaths than patients 75, pathological stage, major complications (Clavien–Dindo III+), and ECCG grade III anastomotic leak were independently associated with worse survival. Major complications had a markedly greater adverse impact on long-term survival in older patients, with five-year survival falling to 7.7% following Clavien–Dindo III+ events. Conclusion Carefully selected patients aged over 75 can achieve meaningful long-term survival following Ivor–Lewis oesophagectomy; however, major postoperative complications—particularly anastomotic leaks—are associated with profound and age-dependent reductions in survival. These findings underscore the importance of meticulous patient selection, optimisation, and multidisciplinary care to mitigate complications in elderly patients undergoing oesophagectomy.
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Authors Mr Amar Lakhani, ASHRA F TOKHI, Fady Youssef, Angel Johnson, Jonathon Ritter, Carlo Mazzucchelli, Ravinder Vohra, Simon Parsons
Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.133
URL
https://doi.org/10.1093/dote/doag077.133
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