Preoperative transferrin level is a novel indicator of short- and long-term outcomes after esophageal cancer surgery

Summary Textbook outcome for esophageal cancer surgery is a composite quality measure including 10 short-term surgical outcomes reflecting an uneventful perioperative course. Achieved textbook outcome is associated with improved long-term survival. This study aimed to update the original textbook outcome based on international consensus. Forty-five international expert esophageal cancer surgeons received a personal invitation to evaluate the 10 items in the original textbook outcome for esophageal cancer surgery and to rate 18 additional items divided over seven subcategories for their importance in the updated textbook outcome. Items were included in the updated textbook outcome if ≥80% of the respondents agreed on inclusion. In case multiple items within one subcategory reached ≥80% agreement, only the most inclusive item with the highest agreement rate was included. With a response rate of 80%, 36 expert esophageal cancer surgeons, from 34 hospitals, 16 countries, and 4 continents responded to this international survey. Based on the inclusion criteria, the updated quality indicator ‘textbook outcome for esophageal cancer surgery’ should consist of: tumor-negative resection margins, ≥20 lymph nodes retrieved and examined, no intraoperative complication, no complications Clavien–Dindo ≥III, no ICU/MCU readmission, no readmission related to the surgical procedure, no anastomotic leakage, no hospital stay ≥14 days, and no in-hospital mortality. This study resulted in an international consensus-based update of a quality measure, textbook outcome for esophageal cancer surgery. This updated textbook outcome should be implemented in quality assurance programs for centers performing esophageal cancer surgery, and could standardize quality measures used internationally.

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Short- and Long-Term Outcomes of Larynx-Preserving Surgery for Cervical Esophageal Cancer: Analysis of 100 Consecutive Cases

Annals of Surgical Oncology ◽

10.1245/s10434-016-5511-x ◽

2016 ◽

Vol 23 (S5) ◽

pp. 858-865 ◽

Cited By ~ 6

Author(s):

Tomoki Makino ◽

Makoto Yamasaki ◽

Yasuhiro Miyazaki ◽

Tsuyoshi Takahashi ◽

Yukinori Kurokawa ◽

...

Keyword(s):

Esophageal Cancer ◽

Long Term Outcomes ◽

Cervical Esophageal Cancer ◽

Short And Long Term

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High World Heath Organization Performance Status Is Associated With Short And Long-term Outcomes After Colorectal Cancer Surgery

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000001982 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Rasmus Dahlin Bojesen ◽

Thea Helene Degett ◽

Susanne Oksbjerg Dalton ◽

Ismail Gögenur

Keyword(s):

Colorectal Cancer ◽

Performance Status ◽

Cancer Surgery ◽

Organization Performance ◽

Long Term Outcomes ◽

Colorectal Cancer Surgery ◽

Short And Long Term ◽

High World

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723 TWO- VS. THREE-FIELD LYMPHADENECTOMY FOR ESOPHAGEAL CANCER. A SYSTEMATIC REVIEW AND META-ANALYSIS OF SHORT- AND LONG-TERM OUTCOMES.

Diseases of the Esophagus ◽

10.1093/dote/doab052.723 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Letícia Nogueira Datrino ◽

Clara Lucato Santos ◽

Guilherme Tavares ◽

Luca Schiliró Tristão ◽

Maria Carolina Andrade Serafim ◽

...

Keyword(s):

Systematic Review ◽

Esophageal Cancer ◽

Meta Analysis ◽

Operation Time ◽

Extended Lymphadenectomy ◽

Long Term Outcomes ◽

Term Survival ◽

Long Term Survival ◽

Short And Long Term

Abstract Nowadays, there is still no consensus about the benefits of adding neck lymphadenectomy to the traditional two-fields esophagectomy. An extended lymphadenectomy could potentially increase operation time and the risks for postoperative complications. However, extended lymphadenectomy allows resection of cervical nodes at risk for metastases, potentially increasing long-term survival rates. This study aims to estimate whether cervical prophylactic lymphadenectomy for esophageal cancer influences short- and long-term outcomes through a systematic review of literature and meta-analysis. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, and Lilacs (BVS). The inclusion criteria were: (1) studies that compare two-field vs. three-field esophagectomy; (2) adults (>18 years); (3) articles that analyze short- or long-term outcomes; and (4) clinical trials or cohort studies. The results were summarized by forest plots, with effect size (ES) or risk difference (RD) and 95% CI. Results Twenty-five articles were selected, comprising 8,954 patients. Three-field lymphadenectomy was associated to higher operation time (ES: -1.51; 95%CI -1.84, −1.18) and higher blood loss (ES: -0.24; 95%CI: −0.37, −0.11). Also, neck lymphadenectomy inputs additional risk for pulmonary complications (RD: 0.03; 95%CI: 0.01, 0.05). No difference was noted for morbidity (RD: 0.01; 95%CI: −0.01, 0.03); leak (−0.02; 95%CI: −0.07, 0.03); postoperative mortality (RD: 0.00; 95%CI: −0.00, 0.01), and hospital stay (ES: -0.05; 95%CI -0.20, 0.10). Three-field lymphadenectomy allowed higher number of retrieved lymph nodes (MD: -1.51; 95%CI -1.84, −1.18), but did not increase the overall survival (HR: 1.11; 95%CI: 0.96, 1.26). Conclusion Prophylactic neck lymphadenectomy for esophageal cancer should be performed with caution once it is associated with poorer short-term outcomes compared to traditional two-field lymphadenectomy and does not improve long-term survival. Future esophageal cancer studies should determine the subgroup of patients who could benefit from prophylactic neck lymphadenectomy in long-term outcomes.

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