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Long-term survival is not affected by severity of complications following esophagectomy

Lookup NU author(s): Dr Jakub Chmelo, Pooja Prasad, Professor Alexander PhillipsORCiD

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Abstract

© 2024 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical OncologyIntroduction: Outcomes following esophagectomy for esophageal cancer have continued to improve over the last 30 years. Post-operative complications impact upon peri-operative and short-term survival but the effect on long-term survival remains debated. This study aims to investigate the effect of post-operative complications on long-term survival following esophagectomy. Materials and methods: All patients who underwent an esophagectomy between January 2010 and January 2019 were included from a single high-volume center. Data was collected contemporaneously. 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), at 30 days. To correct for short-term mortality effects, those who died during the index hospital admission were excluded. Overall survival was analyzed using Kaplan-Meier and log rank testing. Results: The study cohort comprised 721 patients. There were 42.4% (306/721), 29.5% (213/721) and 25.7% (185/721) in the Clavien-Dindo 0–1, Clavien-Dindo 2, and Clavien-Dindo 3–4 group respectively. Seventeen patients (2.4%) died during their index hospital admission and were therefore excluded. There was no significant difference between median survival across the 3 groups (50, 57 and 52 months). Across all 3 groups, overall long-term survival rates were equivalent at 1 (87.5%, 84.9%, 83.2%), 3 (59.7%, 59.6%, 54.2%), and 5 years (43.9%, 48.9%, 45.7%) (p = 0.806). The only factors independently associated with survival in this cohort, were male gender, Charlson comorbidity index, and overall pathological stage of disease. Conclusion: Long-term survival is not affected by peri-operative complications, irrespective of severity, following esophagectomy. Further study into the long-term quality of life is required.

Publication metadata

Author(s): Nevins EJ, Chmelo J, Prasad P, Brown J, Phillips AW

Publication type: Article

Publication status: Published

Journal: European Journal of Surgical Oncology

Year: 2024

Volume: 50

Issue: 4

Print publication date: 01/04/2024

Online publication date: 28/02/2024

Acceptance date: 25/02/2024

ISSN (print): 0748-7983

ISSN (electronic): 1532-2157

Publisher: W.B. Saunders Ltd

URL: https://doi.org/10.1016/j.ejso.2024.108232

DOI: 10.1016/j.ejso.2024.108232

PubMed id: 38430703

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