European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
Impact of surgeon age on long-term prognosis and surgical safety in patients undergoing esophagectomy: a cohort study.
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Chen Peinan, Ren TongTong, Yang Funa, Yang Yongli, Jia Xiaocan, Wang Wei
Аннотация
BACKGROUND: This ambispective cohort study aimed to explore the influence of surgeon age on long-term prognosis and surgical safety in esophagectomy patients, as well as in different surgical approaches.
METHODS: Patients who underwent esophagectomy at Henan Cancer Hospital between 2015 and 2016 were included and followed up until July 2022. The primary endpoints were 5-year overall survival (OS) and disease-free survival (DFS). The secondary outcome was surgical safety. Multivariable Cox regression analysis was performed to assess the impact of surgeon age on OS and DFS, and propensity score matching (PSM) was conducted to balance potential confounding factors.
RESULTS: A total of 1761 patients were included with a median follow-up time of 61.73 months. The 5-year OS and DFS for <50 years surgeons were 65.41 % and 60.34 %, and they were 61.19 % and 57.35 % for ≥50 years surgeons. In the multivariate Cox regression analysis, operations performed by older surgeons were associated with higher risks of reduced survival (OS: HR = 1.20, 95 % CI: 1.03-1.40; DFS: HR = 1.16, 95 % CI: 1.00-1.35). No differences were observed in the number of lymph node dissection and incidence of vascular cancer thrombus. Similar results were seen with OS in patients underwent open esophagectomy and PSM.
CONCLUSIONS: This study indicated that increasing surgeon age may reduce the long-term survival rate especially in patients underwent open esophagectomy, but not of surgical safety.
METHODS: Patients who underwent esophagectomy at Henan Cancer Hospital between 2015 and 2016 were included and followed up until July 2022. The primary endpoints were 5-year overall survival (OS) and disease-free survival (DFS). The secondary outcome was surgical safety. Multivariable Cox regression analysis was performed to assess the impact of surgeon age on OS and DFS, and propensity score matching (PSM) was conducted to balance potential confounding factors.
RESULTS: A total of 1761 patients were included with a median follow-up time of 61.73 months. The 5-year OS and DFS for <50 years surgeons were 65.41 % and 60.34 %, and they were 61.19 % and 57.35 % for ≥50 years surgeons. In the multivariate Cox regression analysis, operations performed by older surgeons were associated with higher risks of reduced survival (OS: HR = 1.20, 95 % CI: 1.03-1.40; DFS: HR = 1.16, 95 % CI: 1.00-1.35). No differences were observed in the number of lymph node dissection and incidence of vascular cancer thrombus. Similar results were seen with OS in patients underwent open esophagectomy and PSM.
CONCLUSIONS: This study indicated that increasing surgeon age may reduce the long-term survival rate especially in patients underwent open esophagectomy, but not of surgical safety.