Impact of postoperative complications on survival after oesophagectomy for oesophageal cancer.

Bundred, J R and Hollis, A C and Evans, R and Hodson, James and Whiting, J L and Griffiths, Ewen A (2020) Impact of postoperative complications on survival after oesophagectomy for oesophageal cancer. BJS open. ISSN 2474-9842.

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Official URL: https://bjssjournals.onlinelibrary.wiley.com/doi/f...

Abstract

BACKGROUND

Recent evidence suggests that complications after oesophagectomy may decrease short- and long-term survival of patients with oesophageal cancer. This study aimed to analyse the impact of complications on survival in a Western cohort.

METHODS

Complications after oesophagectomy were recorded for all patients operated on between January 2006 and February 2017, with severity defined using the Clavien-Dindo classification. Associations between complications and overall and recurrence-free survival were assessed using univariable and multivariable Cox regression models.

RESULTS

Of 430 patients, 292 (67·9 per cent) developed postoperative complications, with 128 (39·8 per cent) classified as Clavien-Dindo grade III or IV. No significant associations were detected between Clavien-Dindo grade and either tumour (T) (P = 0·071) or nodal (N) status (P = 0·882). There was a significant correlation between Clavien-Dindo grade and ASA fitness grade (P = 0·032). In multivariable analysis, overall survival in patients with Clavien-Dindo grade I complications was similar to that in patients with no complications (hazard ratio (HR) 0·97, P = 0·915). However, patients with grade II and IV complications had significantly shorter overall survival than those with no complications: HR 1·64 (P = 0·007) and 1·74 (P = 0·013) respectively.

CONCLUSION

Increasing severity of complications after oesophagectomy was associated with decreased overall survival. Prevention of complications should improve survival.

Item Type: Article
Subjects: QZ Pathology. Oncology
WI Digestive system. Gastroenterology
Divisions: Planned IP Care > Gastroentrology
Planned IP Care > Oncology and Clinical Haematology
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Depositing User: Mr Muneeb Liaquat
Date Deposited: 21 Feb 2020 14:37
Last Modified: 21 Feb 2020 14:37
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2873

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