Major Post-Operative Complications Predict Long-Term Survival After Esophagectomy in Patients with Adenocarcinoma of the Esophagus

2014 ◽  
Vol 39 (1) ◽  
pp. 216-222 ◽  
Author(s):  
Guillaume Luc ◽  
Marlène Durand ◽  
Laurence Chiche ◽  
Denis Collet
2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Edward J Nevins ◽  
Jakub Chmelo ◽  
Joshua Brown ◽  
Pooja Prasad ◽  
Alexander W Phillips

Abstract Background Outcomes following oesophagectomy for oesophageal cancer continue to improve, but complications are common and can result in significant morbidity. Post-operative complications are known to impact upon peri-operative and short-term survival but the effect on long-term survival remains unclear. The aim of this study is to investigate the effect of post-operative complications on long-term survival following oesophagectomy. Methods A contemporaneously maintained database from a single centre was reviewed. All patients who underwent oesophagectomy between January 2010 and January 2019 were included. Patients were separated into three groups, those who experienced no or very minor complications (Clavien-Dindo 0 or 1), minor complications (Clavien-Dindo 2), and major complications (Clavien-Dindo 3-4). Those who died during the index hospital admission were excluded to correct for short-term mortality effects. Overall survival was analysed using Kaplan-Meier and log rank testing. Results Seven hundred and twenty-three patients underwent oesophagectomy during this time. Seventeen (2.4%) died during their index hospital stay, and were excluded from the survival analysis. The 30- and 90- day mortality was 1.1% (8/723) and 2.4% (17/723) respectively. There were 43.2% (305/706), 30.2% (213/706) and 26.6% (188/706) in the Clavien-Dindo 0-1, Clavien-Dindo 2, and Clavien-Dindo 3-4 group respectively. Median survival across the three groups was equivalent (50, 57 and 51 months). Across all three groups, overall long-term survival rates were equivalent at 1 (87.5%, 84.9%, 83.5%), 5 (44.2%, 48.9%, 44.7%) and 10 years (36.7%, 36.0%, 36.7%) (p = 0.730). Conclusions Long term survival is not affected by complications, irrespective of severity, following oesophagectomy.


2020 ◽  
Author(s):  
Siddharth Pahwa ◽  
Annalisa Bernabei ◽  
Hartzell Schaff ◽  
John Stulak ◽  
Kevin Greason ◽  
...  

Author(s):  
Siddharth Pahwa

Risk models were developed to provide clinicians and hospitals with a tool to evaluate risk-adjusted outcomes and to guide quality improvement. The Society of Thoracic Surgeons (STS) Predicted Risk of Mortality (PROM) is the most commonly used risk algorithm, others being the EuroSCORE logistic and additive algorithm and the Ambler Risk Score. These models utilize pre-operative patient characteristics to predict operative risk and early outcomes. Although a great deal of effort has gone into models to predict short-term patient outcomes after common cardiac operations, there has been relatively little effort to develop a statistical algorithm to predict long-term outcomes. Moreover, no risk model takes into account early post-operative complications to construct an algorithm to predict long-term outcomes. The formulation of a risk stratification score based on post-operative complications following common cardiac surgical procedures may be used to estimate the likelihood of long-term survival for individual complications, as well as various permutations and combinations of complications. This may have profound implications in devising strategies to prevent the most devastating combination of complications. Also, this may assist in informing patients and families of the predicted survival after a particular complication or a combination of complications. As Dokollari et all pointed out, there is impetus towards the direction of formulating a risk stratification score, and this may indeed be the need of the hour.


2000 ◽  
Vol 111 (1) ◽  
pp. 363-370 ◽  
Author(s):  
Katsuto Takenaka ◽  
Mine Harada ◽  
Tomoaki Fujisaki ◽  
Koji Nagafuji ◽  
Shinichi Mizuno ◽  
...  

2001 ◽  
Vol 120 (5) ◽  
pp. A747-A748
Author(s):  
S DRESNER ◽  
A IMMMANUEL ◽  
P LAMB ◽  
S GRIFFIN

2006 ◽  
Vol 175 (4S) ◽  
pp. 355-355
Author(s):  
Manuel Eisenberg ◽  
John S. Lam ◽  
Rakhee H. Goel ◽  
Allan J. Pantuck ◽  
Robert A. Figlin ◽  
...  

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