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Background: Surgery is still the best way for treatment of esophageal cancer. The increase in life expectancy and the rising incidence of esophageal tumors have led to a great number of elderly candidates for complex surgery. The purpose of this study was to evaluate the effects of advanced age (70 years or more) on the surgical outcome of esophagectomy for esophageal cancer at a single high-volume center. Materials and Methods: Between January 2000 and April 2006, 480 cases with esophageal cancer underwent esophagectomy in the referral cancer institute. One hundred sixty-five patients in the elderly group (70 years old or more) were compared with 315 patients in the younger group (< 70 years). All in-hospital morbidity and mortality were studied. Results: The range of age was 38-84 years, with a mean of 58.7. The mean age of the elderly and younger groups was 74 and 53.2, respectively. In the younger group, 70 patients (22.2%) and in the elderly group, 39 patients (23.6%) were complicated ( P 0.72).The most common complications in the two groups were pulmonary complications (9.8% in younger and 10.3% in elderly) ( P 0.87). Rates of anastomotic leakage and cardiac complications were also similar between the two groups. Hospital mortality rates in younger and elderly patients were 2.8% and 3%, respectively. There was no significant difference between the two groups in morbidities and mortality ( P -value > 0.05). Conclusions: With increased experience and care, the outcomes of esophagectomy in elderly patients are comparable to young patients. Advanced age alone is not a contraindication for esophagectomy.

Background: Anastomotic leakage after esophagectomy remains an important source of postoperative morbidity in spite of advances in the management of these patients. The aim of this study is to identify the predictive factors of cervical anastomotic leakage and its consequences after esophagectomy in patients with esophageal cancer treated in a high volume cancer center. Materials and Methods: This retrospective study was conducted on 418 patients with esophageal carcinoma who underwent esophagectomy in a referral cancer center between 2001 and 2006. Demographic, clinicopathologic, and surgical data were collected from medical charts. Univariate and multivariate analyses were performed and odds ratio (OR) with 95% confidence intervals (CI 95%) were calculated. Results: Predictive factors of leakage in univariate analysis were history of hypertension (P=0.003), diabetes mellitus (P=0.008), forced expiratory volume in one second percent predicted (FEV1%) (P=0.024), preoperative serum creatinine level (P=0.004), and degree of differentiation of the tumor (P=0.014); however, multivariate regression analysis identified history of hypertension (OR 7.2, [CI95%:1.9 to 28.1]; P=0.004) and serum creatinine level > 0.85 mg/dl (OR 3.1, [CI95%:1.04 to 9.04]; P=0.042) as independently significant risk factors. Pulmonary complications (P=0.042) and length of hospital stay (P < 0.0001) were observed significantly more in patients with anastomotic leakage. Cervical leakage was not associated with increased mortality rate (P=0.312). Conclusion: Preoperative conditions like hypertension and higher creatinine levels predict development of cervical anastomotic leakage after esophageal cancer surgery. Postoperative consequences accompanying leakage include pulmonary complication and prolonged hospitalization. [ABSTRACT FROM AUTHOR]

Abstract- Malignant tumors of pancreas are usually primary neoplasms and pancreatic metastases are rare findings. We are reporting a case of squamous cell carcinoma (SCC) of the esophagus with pancreatic metastasis. A 59-year old woman was admitted with chief complaint of abdominal pain and mass. She was a known case of esophageal SCC since 4 years before when she had undergone transthoracic esophagectomy and cervical esophago-gastrostomy. In order to evaluate recent abdominal mass, CT scan was done which revealed septated cystic lesion in the body and the tail of the pancreas. Palliative resection of the tumor was performed and its histological study showed SCC compatible with her previously diagnosed esophageal cancer. [ABSTRACT FROM AUTHOR]