Long-term Outcomes Following Esophagectomy in Older and Younger Adults with Esophageal Cancer
Background Patterns of overall and disease-free survival after esophagectomy for esophageal cancer in older adults have not been carefully studied. Methods Retrospective analysis of all patients with esophageal cancer undergoing esophagectomy from 2005 to 2020 at our institution was performed. Diffe...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2022-06, Vol.26 (6), p.1119-1131 |
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| creator | Dezube, Aaron R. Cooper, Lisa Mazzola, Emanuele Dolan, Daniel P. Lee, Daniel N. Kucukak, Suden De Leon, Luis E. Dumontier, Clark Ademola, Bayonle Polhemus, Emily Bueno, Raphael White, Abby Swanson, Scott J. Jaklitsch, Michael T. Frain, Laura Wee, Jon O. |
| description | Background
Patterns of overall and disease-free survival after esophagectomy for esophageal cancer in older adults have not been carefully studied.
Methods
Retrospective analysis of all patients with esophageal cancer undergoing esophagectomy from 2005 to 2020 at our institution was performed. Differences in outcomes were stratified by age groups, |
| doi_str_mv | 10.1007/s11605-022-05295-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9474270</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2645857178</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-a26b1d55b2b7677c11802f7552aec48d99f23685b22a70782b2b313f5ff988553</originalsourceid><addsrcrecordid>eNp9kUFv1DAQhS1ERUvhD3BAlrhwMdiOJ3YuSNWqLUgr7QUkOCDL6zjZVI692AlV--vr7bZb4MDJI803b974IfSG0Q-MUvkxM1ZTIJRzQoE3QG6foROmZEVEzevnpaYNIxzg-zF6mfMVpUxSpl6g4woqkLUUJ-jnMoaeTC6NeDVPNo4u44vofbweQo_Pc9xuTO_sFMcbPAS88q1L2IQW_4hz6Et91s5-yvh6mDYH3Hi8MMG69AoddcZn9_rhPUXfLs6_Lj6T5eryy-JsSayQYiKG12vWAqz5uriSljFFeScBuHFWqLZpOl7VqvS5kVQqXsCKVR10XaMUQHWKPu11t_N6dK11YUrG620aRpNudDSD_rsTho3u42_dlP1c0iLw_kEgxV-zy5Meh2yd9ya4OGfNawEKJJOqoO_-Qa_inEI5r1BSQC2U2Dnie8qmmHNy3cEMo3qXnt6np0t6-j49fVuG3v55xmHkMa4CVHsgl9bu-592_0f2Dpc6pj4</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2674564845</pqid></control><display><type>article</type><title>Long-term Outcomes Following Esophagectomy in Older and Younger Adults with Esophageal Cancer</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Dezube, Aaron R. ; Cooper, Lisa ; Mazzola, Emanuele ; Dolan, Daniel P. ; Lee, Daniel N. ; Kucukak, Suden ; De Leon, Luis E. ; Dumontier, Clark ; Ademola, Bayonle ; Polhemus, Emily ; Bueno, Raphael ; White, Abby ; Swanson, Scott J. ; Jaklitsch, Michael T. ; Frain, Laura ; Wee, Jon O.</creator><creatorcontrib>Dezube, Aaron R. ; Cooper, Lisa ; Mazzola, Emanuele ; Dolan, Daniel P. ; Lee, Daniel N. ; Kucukak, Suden ; De Leon, Luis E. ; Dumontier, Clark ; Ademola, Bayonle ; Polhemus, Emily ; Bueno, Raphael ; White, Abby ; Swanson, Scott J. ; Jaklitsch, Michael T. ; Frain, Laura ; Wee, Jon O.</creatorcontrib><description><![CDATA[Background
Patterns of overall and disease-free survival after esophagectomy for esophageal cancer in older adults have not been carefully studied.
Methods
Retrospective analysis of all patients with esophageal cancer undergoing esophagectomy from 2005 to 2020 at our institution was performed. Differences in outcomes were stratified by age groups, < 75 and ≥ 75 years old, and two time periods, 2005–2012 and 2013–2020.
Results
A total of 1135 patients were included: 979 (86.3%) patients were < 75 (86.3%), and 156 (13.7%) were ≥ 75 years old. Younger patients had fewer comorbidities, better nutritional status, and were more likely to receive neoadjuvant and adjuvant therapy (all
p
< 0.05). However, tumor stage and operative approach were similar, except for increased performance of the McKeown technique in younger patients (
p
= 0.02). Perioperatively, younger patients experienced fewer overall and grade II complications (both
p
< 0.05). They had better overall survival (log-rank
p
-value < 0.001) and median survival, 62.2 vs. 21.5 months (
p
< 0.05). When stratified by pathologic stage, survival was similar for yp0 and pathologic stage II disease (both log-rank
p
-value > 0.05). Multivariable Cox models showed older age (≥ 75 years old) had increased hazard for reduced overall survival (HR 2.04 95% CI 1.5–2.8;
p
< 0.001) but not disease-free survival (HR 1.1 95% CI 0.78–1.6;
p
= 0.54). Over time, baseline characteristics remained largely similar, while stage became more advanced with a rise in neoadjuvant use and increased performance of minimally invasive esophagectomy (all
p
< 0.05). While overall complication rates improved (
p
< 0.05), overall and recurrence-free survival did not. Overall survival was better in younger patients during both time periods (both log-rank
p
< 0.05).
Conclusions
Despite similar disease-free survival rates, long-term survival was decreased in older adults as compared to younger patients. This may be related to unmeasured factors including frailty, long-term complications after surgery, and competing causes of death. However, our results suggest that survival is similar in those with complete pathologic responses.]]></description><identifier>ISSN: 1091-255X</identifier><identifier>ISSN: 1873-4626</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-022-05295-z</identifier><identifier>PMID: 35357674</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Age groups ; Aged ; Body mass index ; Cancer therapies ; Cardiovascular disease ; Chronic obstructive pulmonary disease ; Esophageal cancer ; Esophageal Neoplasms - pathology ; Esophagectomy - methods ; Gastroenterology ; Gastrointestinal surgery ; Humans ; Medicine ; Medicine & Public Health ; Neoadjuvant Therapy - methods ; Older people ; Original Article ; Ostomy ; Patients ; Retrospective Studies ; Robotics ; Statistical analysis ; Surgery ; Surgical outcomes ; Thoracic surgery ; Treatment Outcome ; Variables</subject><ispartof>Journal of gastrointestinal surgery, 2022-06, Vol.26 (6), p.1119-1131</ispartof><rights>The Society for Surgery of the Alimentary Tract 2022</rights><rights>2022. The Society for Surgery of the Alimentary Tract.</rights><rights>The Society for Surgery of the Alimentary Tract 2022.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-a26b1d55b2b7677c11802f7552aec48d99f23685b22a70782b2b313f5ff988553</citedby><cites>FETCH-LOGICAL-c474t-a26b1d55b2b7677c11802f7552aec48d99f23685b22a70782b2b313f5ff988553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-022-05295-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-022-05295-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35357674$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dezube, Aaron R.</creatorcontrib><creatorcontrib>Cooper, Lisa</creatorcontrib><creatorcontrib>Mazzola, Emanuele</creatorcontrib><creatorcontrib>Dolan, Daniel P.</creatorcontrib><creatorcontrib>Lee, Daniel N.</creatorcontrib><creatorcontrib>Kucukak, Suden</creatorcontrib><creatorcontrib>De Leon, Luis E.</creatorcontrib><creatorcontrib>Dumontier, Clark</creatorcontrib><creatorcontrib>Ademola, Bayonle</creatorcontrib><creatorcontrib>Polhemus, Emily</creatorcontrib><creatorcontrib>Bueno, Raphael</creatorcontrib><creatorcontrib>White, Abby</creatorcontrib><creatorcontrib>Swanson, Scott J.</creatorcontrib><creatorcontrib>Jaklitsch, Michael T.</creatorcontrib><creatorcontrib>Frain, Laura</creatorcontrib><creatorcontrib>Wee, Jon O.</creatorcontrib><title>Long-term Outcomes Following Esophagectomy in Older and Younger Adults with Esophageal Cancer</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description><![CDATA[Background
Patterns of overall and disease-free survival after esophagectomy for esophageal cancer in older adults have not been carefully studied.
Methods
Retrospective analysis of all patients with esophageal cancer undergoing esophagectomy from 2005 to 2020 at our institution was performed. Differences in outcomes were stratified by age groups, < 75 and ≥ 75 years old, and two time periods, 2005–2012 and 2013–2020.
Results
A total of 1135 patients were included: 979 (86.3%) patients were < 75 (86.3%), and 156 (13.7%) were ≥ 75 years old. Younger patients had fewer comorbidities, better nutritional status, and were more likely to receive neoadjuvant and adjuvant therapy (all
p
< 0.05). However, tumor stage and operative approach were similar, except for increased performance of the McKeown technique in younger patients (
p
= 0.02). Perioperatively, younger patients experienced fewer overall and grade II complications (both
p
< 0.05). They had better overall survival (log-rank
p
-value < 0.001) and median survival, 62.2 vs. 21.5 months (
p
< 0.05). When stratified by pathologic stage, survival was similar for yp0 and pathologic stage II disease (both log-rank
p
-value > 0.05). Multivariable Cox models showed older age (≥ 75 years old) had increased hazard for reduced overall survival (HR 2.04 95% CI 1.5–2.8;
p
< 0.001) but not disease-free survival (HR 1.1 95% CI 0.78–1.6;
p
= 0.54). Over time, baseline characteristics remained largely similar, while stage became more advanced with a rise in neoadjuvant use and increased performance of minimally invasive esophagectomy (all
p
< 0.05). While overall complication rates improved (
p
< 0.05), overall and recurrence-free survival did not. Overall survival was better in younger patients during both time periods (both log-rank
p
< 0.05).
Conclusions
Despite similar disease-free survival rates, long-term survival was decreased in older adults as compared to younger patients. This may be related to unmeasured factors including frailty, long-term complications after surgery, and competing causes of death. However, our results suggest that survival is similar in those with complete pathologic responses.]]></description><subject>Age groups</subject><subject>Aged</subject><subject>Body mass index</subject><subject>Cancer therapies</subject><subject>Cardiovascular disease</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophagectomy - methods</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoadjuvant Therapy - methods</subject><subject>Older people</subject><subject>Original Article</subject><subject>Ostomy</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Robotics</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Thoracic surgery</subject><subject>Treatment Outcome</subject><subject>Variables</subject><issn>1091-255X</issn><issn>1873-4626</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUFv1DAQhS1ERUvhD3BAlrhwMdiOJ3YuSNWqLUgr7QUkOCDL6zjZVI692AlV--vr7bZb4MDJI803b974IfSG0Q-MUvkxM1ZTIJRzQoE3QG6foROmZEVEzevnpaYNIxzg-zF6mfMVpUxSpl6g4woqkLUUJ-jnMoaeTC6NeDVPNo4u44vofbweQo_Pc9xuTO_sFMcbPAS88q1L2IQW_4hz6Et91s5-yvh6mDYH3Hi8MMG69AoddcZn9_rhPUXfLs6_Lj6T5eryy-JsSayQYiKG12vWAqz5uriSljFFeScBuHFWqLZpOl7VqvS5kVQqXsCKVR10XaMUQHWKPu11t_N6dK11YUrG620aRpNudDSD_rsTho3u42_dlP1c0iLw_kEgxV-zy5Meh2yd9ya4OGfNawEKJJOqoO_-Qa_inEI5r1BSQC2U2Dnie8qmmHNy3cEMo3qXnt6np0t6-j49fVuG3v55xmHkMa4CVHsgl9bu-592_0f2Dpc6pj4</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Dezube, Aaron R.</creator><creator>Cooper, Lisa</creator><creator>Mazzola, Emanuele</creator><creator>Dolan, Daniel P.</creator><creator>Lee, Daniel N.</creator><creator>Kucukak, Suden</creator><creator>De Leon, Luis E.</creator><creator>Dumontier, Clark</creator><creator>Ademola, Bayonle</creator><creator>Polhemus, Emily</creator><creator>Bueno, Raphael</creator><creator>White, Abby</creator><creator>Swanson, Scott J.</creator><creator>Jaklitsch, Michael T.</creator><creator>Frain, Laura</creator><creator>Wee, Jon O.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220601</creationdate><title>Long-term Outcomes Following Esophagectomy in Older and Younger Adults with Esophageal Cancer</title><author>Dezube, Aaron R. ; Cooper, Lisa ; Mazzola, Emanuele ; Dolan, Daniel P. ; Lee, Daniel N. ; Kucukak, Suden ; De Leon, Luis E. ; Dumontier, Clark ; Ademola, Bayonle ; Polhemus, Emily ; Bueno, Raphael ; White, Abby ; Swanson, Scott J. ; Jaklitsch, Michael T. ; Frain, Laura ; Wee, Jon O.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-a26b1d55b2b7677c11802f7552aec48d99f23685b22a70782b2b313f5ff988553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age groups</topic><topic>Aged</topic><topic>Body mass index</topic><topic>Cancer therapies</topic><topic>Cardiovascular disease</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Esophageal cancer</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophagectomy - methods</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoadjuvant Therapy - methods</topic><topic>Older people</topic><topic>Original Article</topic><topic>Ostomy</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Robotics</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Thoracic surgery</topic><topic>Treatment Outcome</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dezube, Aaron R.</creatorcontrib><creatorcontrib>Cooper, Lisa</creatorcontrib><creatorcontrib>Mazzola, Emanuele</creatorcontrib><creatorcontrib>Dolan, Daniel P.</creatorcontrib><creatorcontrib>Lee, Daniel N.</creatorcontrib><creatorcontrib>Kucukak, Suden</creatorcontrib><creatorcontrib>De Leon, Luis E.</creatorcontrib><creatorcontrib>Dumontier, Clark</creatorcontrib><creatorcontrib>Ademola, Bayonle</creatorcontrib><creatorcontrib>Polhemus, Emily</creatorcontrib><creatorcontrib>Bueno, Raphael</creatorcontrib><creatorcontrib>White, Abby</creatorcontrib><creatorcontrib>Swanson, Scott J.</creatorcontrib><creatorcontrib>Jaklitsch, Michael T.</creatorcontrib><creatorcontrib>Frain, Laura</creatorcontrib><creatorcontrib>Wee, Jon O.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Databases</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of gastrointestinal surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dezube, Aaron R.</au><au>Cooper, Lisa</au><au>Mazzola, Emanuele</au><au>Dolan, Daniel P.</au><au>Lee, Daniel N.</au><au>Kucukak, Suden</au><au>De Leon, Luis E.</au><au>Dumontier, Clark</au><au>Ademola, Bayonle</au><au>Polhemus, Emily</au><au>Bueno, Raphael</au><au>White, Abby</au><au>Swanson, Scott J.</au><au>Jaklitsch, Michael T.</au><au>Frain, Laura</au><au>Wee, Jon O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term Outcomes Following Esophagectomy in Older and Younger Adults with Esophageal Cancer</atitle><jtitle>Journal of gastrointestinal surgery</jtitle><stitle>J Gastrointest Surg</stitle><addtitle>J Gastrointest Surg</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>26</volume><issue>6</issue><spage>1119</spage><epage>1131</epage><pages>1119-1131</pages><issn>1091-255X</issn><issn>1873-4626</issn><eissn>1873-4626</eissn><abstract><![CDATA[Background
Patterns of overall and disease-free survival after esophagectomy for esophageal cancer in older adults have not been carefully studied.
Methods
Retrospective analysis of all patients with esophageal cancer undergoing esophagectomy from 2005 to 2020 at our institution was performed. Differences in outcomes were stratified by age groups, < 75 and ≥ 75 years old, and two time periods, 2005–2012 and 2013–2020.
Results
A total of 1135 patients were included: 979 (86.3%) patients were < 75 (86.3%), and 156 (13.7%) were ≥ 75 years old. Younger patients had fewer comorbidities, better nutritional status, and were more likely to receive neoadjuvant and adjuvant therapy (all
p
< 0.05). However, tumor stage and operative approach were similar, except for increased performance of the McKeown technique in younger patients (
p
= 0.02). Perioperatively, younger patients experienced fewer overall and grade II complications (both
p
< 0.05). They had better overall survival (log-rank
p
-value < 0.001) and median survival, 62.2 vs. 21.5 months (
p
< 0.05). When stratified by pathologic stage, survival was similar for yp0 and pathologic stage II disease (both log-rank
p
-value > 0.05). Multivariable Cox models showed older age (≥ 75 years old) had increased hazard for reduced overall survival (HR 2.04 95% CI 1.5–2.8;
p
< 0.001) but not disease-free survival (HR 1.1 95% CI 0.78–1.6;
p
= 0.54). Over time, baseline characteristics remained largely similar, while stage became more advanced with a rise in neoadjuvant use and increased performance of minimally invasive esophagectomy (all
p
< 0.05). While overall complication rates improved (
p
< 0.05), overall and recurrence-free survival did not. Overall survival was better in younger patients during both time periods (both log-rank
p
< 0.05).
Conclusions
Despite similar disease-free survival rates, long-term survival was decreased in older adults as compared to younger patients. This may be related to unmeasured factors including frailty, long-term complications after surgery, and competing causes of death. However, our results suggest that survival is similar in those with complete pathologic responses.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>35357674</pmid><doi>10.1007/s11605-022-05295-z</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1091-255X |
| ispartof | Journal of gastrointestinal surgery, 2022-06, Vol.26 (6), p.1119-1131 |
| issn | 1091-255X 1873-4626 1873-4626 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9474270 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Age groups Aged Body mass index Cancer therapies Cardiovascular disease Chronic obstructive pulmonary disease Esophageal cancer Esophageal Neoplasms - pathology Esophagectomy - methods Gastroenterology Gastrointestinal surgery Humans Medicine Medicine & Public Health Neoadjuvant Therapy - methods Older people Original Article Ostomy Patients Retrospective Studies Robotics Statistical analysis Surgery Surgical outcomes Thoracic surgery Treatment Outcome Variables |
| title | Long-term Outcomes Following Esophagectomy in Older and Younger Adults with Esophageal Cancer |
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