Surgical complications and long-term survival after esophagectomy for cancer in a nationwide Swedish cohort study

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• 作者：M. Rutegå ; rd^a ; ^{martin.rutegard@ki.se} ; P. Lagergren^a ; I. Rouvelas^a ; R. Mason^b ; J. Lagergren^a ; ^c
• 关键词：Esophagus ; Population-based ; Neoplasm ; Surgery ; Mortality ; Leak
• 刊名：European Journal of Surgical Oncology (EJSO)
• 出版年：2012
• 期刊代码：121_07487983
• 类别：med
• 出版时间：July, 2012
• 卷：38
• 期：7
• 页码：555-561
• 文件大小：378 K

摘要

Aims

Acute surgical complications after esophageal resection for cancer may decrease the long-term survival. Previous results on this topic are conflicting and no population-based studies are available.

Methods

A prospective, nationwide Swedish study was conducted in 2001-2010. Eligible patients comprised those afflicted by esophageal or cardia cancer and underwent surgical resection in Sweden in 2001-2005. Details concerning patient and tumor characteristics, surgical procedures, and postoperative surgical complications were collected prospectively. Follow-up for mortality, starting from 90聽days after the surgery, was done until May 2010. Cox proportional-hazards regression was performed to estimate hazard ratios (HRs) and 95%confidence intervals (CIs), adjusted for age, tumor stage, sex, histology, comorbidity, surgical approach and surgical radicality.

Results

Among 567 included patients who survived at least 90 days postoperatively, 130 (22.9%) sustained a predefined surgical complication within 30 days of surgery. The adjusted HR of mortality was increased in patients who sustained surgical complications, compared to patients without such complications (HR 1.29, 95%CI 1.02-1.63).

Conclusions

The occurrence of surgical complications might be an independent predictor for poorer long-term survival in patients resected for esophageal cancer, even in patients who survived the postoperative period.