Respiratory complications after oesophagectomy for cancer do not affect disease-free survival

D'Annoville, Thomas; D’Journo, Xavier Benoit; Trousse, Delphine; Brioude, Geoffrey; Dahan, Laétitia; Seitz, Jean François; Doddoli, Christophe; Thomas, Pascal

doi:10.1093/ejcts/ezs080

Cited by 45 publications

(59 citation statements)

References 21 publications

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“…These results agree with D'Annoville et al, who found that technical complications were associated with worse immediate hospital outcomes, but did not affect longterm survival 8 . In addition, major postoperative morbidities were found to significantly increase patient LOS.…”

Section: Discussionsupporting

confidence: 92%

Major Perioperative Morbidity Does Not Affect Long‐Term Survival in Patients Undergoing Esophagectomy for Cancer of the Esophagus or Gastroesophageal Junction

et al. 2012

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Introduction 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 long‐term 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 long‐term survival of patients undergoing resection for curative intent. Methods We 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 log‐rank tests. Multivariate analysis was performed with continuous and categorical variables as predictors of survival, and examined with logistic regression and odds ratio confidence intervals. Results There 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 long‐term survival, although patients with grade IV (serious) complications did have a decreased survival (p = 0.15). Predictors of survival showed that the minimally invasive type esophagectomy (p = 0.0004) and pathologic stage (p = 0.0007) were determining factors. There was a significant difference in overall survival among patients who experienced pneumonia (p = 0.00016) and respiratory complications (p = 0.0004), but this was not significant on multivariate analysis. Conclusions In this single‐institution series, we found that major perioperative morbidity did not have a negative impact on long‐term survival which is different than previous series. The impact of tumor characteristics at time of resection on long‐term survival is of most importance.

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Section: Discussionsupporting

confidence: 92%

Major Perioperative Morbidity Does Not Affect Long‐Term Survival in Patients Undergoing Esophagectomy for Cancer of the Esophagus or Gastroesophageal Junction

et al. 2012

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“…One study found that Japanese patients with postoperative complications had worse prognoses than those without complications, 9 whereas other studies have found no independent effect of surgical complications on patient survival. [12][13][14][15] However, these studies were limited by small sample sizes and low statistical power. Because of the publication bias that results in small studies with ''significant'' results having a much higher likelihood of being published than small studies with null results, the importance of large-scale studies cannot be emphasized strongly enough.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Postoperative Complications in 502 Patients With Surgically Resected Esophageal Squamous Cell Carcinoma

Baba

Yoshida²,

Shigaki³

et al. 2016

Annals of Surgery

176

118

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“…In addition, presenting the potential risk factors associated with pulmonary complications ensures the anticipation of complications by determining preventive strategies. In previous studies, for specific surgical groups, like upper abdominal interventions (4), oesophagectomy (5), total knee arthroplasty (6) or coronary artery bypass surgery (7), preoperative risk factors in the development of PPCs were investigated. The European Society of Anaesthesiology (ESA) performed a multinational, multicentre study called PERISCOPE (Prospective Evaluation of a Risk Score for postoperative pulmonary Complications in Europe), which our clinic also attended.…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors Involved in Development of Postoperative Pulmonary Complications

Saraçoğlu¹,

Yavru²,

Küçükgöncü³

et al. 2014

Turk J Anesth Reanim

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Objective: In the present study, we applied the method of the multi-center Prospective Evaluation of a Risk Score for postoperative pulmonary Complications in Europe (PERISCOPE) study, which was designed to predict postoperative complications and funded by the European Society of Anaesthesiology, to patients in our institution with the aim of prospectively analyzing the postoperative risk factors of pulmonary complications. Methods:One hundred patients over 18 years of age who had emergency or elective non-thoracic or non-obstetric surgery under general anaesthesia or neuraxial blocks were included in the study. Collected data regarding the preoperative and postoperative period were filled in separate forms for all patients.Results: A total of 11 patients developed pulmonary complications. We observed respiratory failure in 8 patients, pleural effusion in 3 patients, atelectasis in 5 patients, bronchospasm in 3 patients, and pneumothorax in 1 patient. In the univariate logistic regression model, patient age, gender, weight, rate of preoperative respiratory symptoms, cough test results, American Society of Anesthesiology (ASA) score, and the duration of surgery did not significantly increase the complication risk (p>0.05). However, in the univariate logistic regression model, the presence of respiratory symptoms increased the risk for complications approximately 5.34-fold (p=0.014). There was an increase in the possibility of complications in parallel with the increase in the duration of postoperative hospital stay (p=0.012). More respiratory symptoms (p=0.019) and longer hospital stay (6.5 vs. 3.5 days respectively, p=0.029) were recorded in patients with postoperative pulmonary complications. Conclusion:Considering patients undergoing non-thoracic or non-obstetric surgery, the prevalence of postoperative pulmonary complications is higher in patients diagnosed with respiratory symptoms in the preoperative period. These complications significantly extend the length of hospital stay.

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Respiratory complications after oesophagectomy for cancer do not affect disease-free survival

Abstract: When postoperative mortality is excluded, postoperative complications do not affect DFS in patients with complete resection. This deserves substantial information regarding the prognosis of subgroup of patients in critical situations where incrementing intensive care is debated.

Cited by 45 publications

References 21 publications

Major Perioperative Morbidity Does Not Affect Long‐Term Survival in Patients Undergoing Esophagectomy for Cancer of the Esophagus or Gastroesophageal Junction

Major Perioperative Morbidity Does Not Affect Long‐Term Survival in Patients Undergoing Esophagectomy for Cancer of the Esophagus or Gastroesophageal Junction

Prognostic Impact of Postoperative Complications in 502 Patients With Surgically Resected Esophageal Squamous Cell Carcinoma

Predictive Factors Involved in Development of Postoperative Pulmonary Complications

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