Postoperative complications and survival after surgical resection of esophageal squamous cell carcinoma
| Autor: | Rikke Vibeke Nielsen, Sebastian Roed Rasmussen, Anne-Sophie Fenger, Mette Siemsen, Hanne Berg Ravn |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty education.field_of_study Proportional hazards model business.industry medicine.medical_treatment Hazard ratio Population Retrospective cohort study Perioperative medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine Esophagectomy 030220 oncology & carcinogenesis medicine Adenocarcinoma 030211 gastroenterology & hepatology Original Article business education Survival analysis |
| Popis: | Background: Resection of esophageal squamous cell carcinoma (SCC) is associated with a frequent occurrence of postoperative complications. Previously, the impact of complications on long-term survival has been explored primarily in mixed squamous cell and adenocarcinoma (AC) populations with conflicting results. In the present study, the influence of postoperative complications on survival following open esophageal resection was investigated exclusively in a western population with SCC. Methods: In a retrospective observational study, all patients undergoing open surgical resection for esophageal SCC at our centre between February 2010 and December 2015 were consecutively included. Pre- and perioperative clinical information, mortality and complications were registered. Results: In the study cohort, 133 patients were enrolled. Eighty-nine patients (67%) experienced one or more postoperative complications. The estimated 5-year survival on the entire population was 57%. Patients without complications had a long-term survival of 52%, whereas in patients with one or more complications survival was reduced to 30% (log rank P=0.039). Cox regression analysis revealed that postoperative complications were associated with an increased mortality risk with an adjusted hazard ratio (HR) of 2.02 (95% CI: 1.1–3.7, P=0.025), specifically sepsis/septic shock and anastomotic leakage significantly reduced long-term survival. Conclusions: We found an improved 5-year survival in patients undergoing surgical resection for SCC compared to previous studies with mixed populations, despite a more frequent occurrence of complications. The presence of postoperative complications significantly reduced the long-term survival with 42%. |
| Databáze: | OpenAIRE |
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