Prognostic Significance of Postoperative Complications After Curative Resection for Patients With Esophageal Squamous Cell Carcinoma

Saeki, Hiroshi; Tsutsumi, Satoshi; Tajiri, H.; Yukaya, Takafumi; Tsutsumi, Ryosuke; Nishimura, Shigeo; Nakaji, Yu; Kudou, Kensuke; Akiyama, S.; Kasagi, Yuta; Nakanishi, Ryota; Nakashima, Yasuhiro; Shimada, Masahiko; Ohgaki, Kippei; Sonoda, Hideto; Oki, Eiji; Maehara, Yoshihiko

doi:10.1097/sla.0000000000001692

Cited by 115 publications

(96 citation statements)

References 24 publications

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“…Of note, Ito et al previously reported on a cohort of patients with colorectal liver metastasis and noted that morbidity was not an independent predictor of recurrence in the entire cohort, but was predictive of recurrence among patients with a low clinical risk score . Similarly, Saeki et al reported that patients with esophageal squamous cell cancer and early stage disease (pStages 0‐II) were more likely to be affected by postoperative complications versus patients with advanced‐stage disease (pStages III and IV) in terms of cancer progression …”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of complications after resection of early stage hepatocellular carcinoma

Margonis

Sasaki

Andreatos

et al. 2017

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Prognostic impact of complications after resection of early stage hepatocellular carcinoma

Margonis

Sasaki

Andreatos

et al. 2017

Journal of Surgical Oncology

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“…The impact of postoperative complications on long‐term survival has been investigated for many cancers , . In some studies , a negative impact of complications following oesophagectomy on long‐term survival was reported. In other studies , , complications did not affect long‐term survival.…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of the impact of postoperative complications on survival after oesophagectomy for cancer

et al. 2018

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BackgroundOesophagectomy has a high risk of postoperative morbidity. The impact of postoperative complications on overall survival of oesophageal cancer remains unclear. This meta‐analysis addressed the impact of complications on long‐term survival following oesophagectomy.MethodsA search of PubMed and Cochrane Library databases was undertaken for systematic review of papers published between January 1995 and August 2016 that analysed the relation between postoperative complications and long‐term survival. In the meta‐analysis, data were pooled. The main outcome was overall survival (OS). Secondary endpoints included disease‐free (DFS) and cancer‐specific (CSS) survival.ResultsA total of 357 citations was reviewed; 21 studies comprising 11 368 patients were included in the analyses. Overall, postoperative complications were associated with significantly decreased 5‐year OS (hazard ratio (HR) 1·16, 95 per cent c.i. 1·06 to 1·26; P = 0·001) and 5‐year CSS (HR 1·27, 1·09 to 1·47; P = 0·002). Pulmonary complications were associated with decreased 5‐year OS (HR 1·37, 1·16 to 1·62; P < 0·001), CSS (HR 1·60, 1·35 to 1·89; P < 0·001) and 5‐year DFS (HR 1·16, 1·00 to 1·33; P = 0·05). Patients with anastomotic leakage had significantly decreased 5‐year OS (HR 1·20, 1·10 to 1·30; P < 0·001), 5‐year CSS (HR 1·81, 1·11 to 2·95; P = 0·02) and 5‐year DFS (HR 1·13, 1·02 to 1·25; P = 0·01).ConclusionPostoperative complications after oesophagectomy, including pulmonary complications and anastomotic leakage, decreased long‐term survival.

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“…Previous research suggests that operative volume, anastomotic location, tumor location/size, cardiopulmonary disease, renal disease, procedure type, ASA score, and diabetes may all be associated with anastomotic leak . A better understanding of characteristics contributing to the leak is critical, as research suggests patients who develop significant complications following esophagectomy have inferior survival outcomes and higher recurrence rates, even when adjusted for characteristics of the patient and disease . Moreover, anastomotic leaks are associated with prolonged hospital stays and higher perioperative morbidity and mortality rates .…”

Section: Introductionmentioning

confidence: 99%

“…A better understanding of characteristics contributing to the leak is critical, as research suggests patients who develop significant complications following esophagectomy have inferior survival outcomes and higher recurrence rates, even when adjusted for characteristics of the patient and disease . Moreover, anastomotic leaks are associated with prolonged hospital stays and higher perioperative morbidity and mortality rates . Identification of characteristics associated with anastomotic leak could permit risk stratification and implementation of targeted interventions to promote early detection and minimize downstream sequella.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for anastomotic leak after esophagectomy for cancer: A NSQIP procedure‐targeted analysis

Hall

Flores

Parshall

et al. 2019

Journal of Surgical Oncology

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Background: Anastomotic leak is the most common major complication after esophagectomy. We investigated the 2016 American College of Surgeons National Surgical Quality Improvement Program esophagectomy targeted database to identify risk factors for anastomotic leak.Methods: Patients who underwent esophagectomy for cancer were included. Patients experiencing an anstomotic leak were identified, and univariate and multivariable logistic regression was performed to identify variables independently associated with anastomotic leak.Results: Of 915 patients included, 83% were male and the median age was 64 years.Patients with anastomotic leak more frequently had additional complications (87% vs 36%, P < .001). Rates of reoperation (64% vs 11%, P < .001) and mortality (8% vs 2%, P = .001) were higher in patients with anastomotic leak. After adjusting for patient and procedure characteristics, prolonged operative time (for each additional 30-minutes; adjusted odds ratios (AOR) 1.068, 95% CI, 1.022-1.115, P = .003), increased preoperative WBC count (for each 3000/µL increase; AOR 1.323, 95% CI, 1.048-1.670, P = .019), pre-existing diabetes (AOR 1.601, 95% CI, 1.012-2.534, P = .045), and perioperative transfusion (AOR 1.777, 95% CI, 1.064-2.965, P = .028) were independently associated with anastomotic leak.Conclusion: Both patient and procedure-related factors are associated with anastomotic leak. Though frequently non-modifiable, these findings could facilitate risk stratification and early detection of anastomotic leak to reduce associated morbidity.

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Prognostic Significance of Postoperative Complications After Curative Resection for Patients With Esophageal Squamous Cell Carcinoma

Abstract: The development of postoperative complications is an independent disease-specific poor prognostic factor after curative resection for patients with less-advanced esophageal squamous cell carcinoma.

Cited by 115 publications

References 24 publications

Prognostic impact of complications after resection of early stage hepatocellular carcinoma

Prognostic impact of complications after resection of early stage hepatocellular carcinoma

Meta-analysis of the impact of postoperative complications on survival after oesophagectomy for cancer

Risk factors for anastomotic leak after esophagectomy for cancer: A NSQIP procedure‐targeted analysis

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