Authors: Brent T Xia Ernest L Rosato Karen A Chojnacki Albert G Crawford Benny Weksler Adam C Berger
Publish Date: 2012/10/02
Volume: 37, Issue: 2, Pages: 408-415
Abstract
The incidence of cancer of the esophagus/GE junction is dramatically increasing but continues to have a dismal prognosis Esophagectomy provides the best opportunity for longterm cure but is hampered by increased rates of perioperative morbidity We reviewed our large institutional experience to evaluate the impact of postoperative complications on the longterm survival of patients undergoing resection for curative intentWe identified 237 patients who underwent esophagogastrectomy with curative intent for cancer between 1994 and 2008 Complications were graded using the previously published Clavien scale Survival was calculated using Kaplan–Meier methodology and survival curves were compared using logrank tests Multivariate analysis was performed with continuous and categorical variables as predictors of survival and examined with logistic regression and odds ratio confidence intervalsThere were 12 5 perioperative deaths The average age of all patients was 62 years and the majority 82 was male Complication grade did not significantly affect longterm survival although patients with grade IV serious complications did have a decreased survival p = 015 Predictors of survival showed that the minimally invasive type esophagectomy p = 00004 and pathologic stage p = 00007 were determining factors There was a significant difference in overall survival among patients who experienced pneumonia p = 000016 and respiratory complications p = 00004 but this was not significant on multivariate analysisIn this singleinstitution series we found that major perioperative morbidity did not have a negative impact on longterm survival which is different than previous series The impact of tumor characteristics at time of resection on longterm survival is of most importance
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