Estimation of physiologic ability and surgical stress (E-PASS) can assess short-term outcome after esophagectomy for esophageal cancer

• Published in: Esophagus : official journal of the Japan Esophageal Society 2013-06, Vol.10 (2), p.86-94
• Main Authors: Yoshida, Naoya, Watanabe, Masayuki, Baba, Yoshifumi, Iwagami, Shiro, Ishimoto, Takatsugu, Iwatsuki, Masaaki, Sakamoto, Yasuo, Miyamoto, Yuji, Ozaki, Nobuyuki, Baba, Hideo
• Format: Article
• Language: English
• Subjects: Cancer therapies; Chemotherapy; Esophageal cancer; Esophagus; Gastroenterology; Gastrointestinal surgery; Medicine; Medicine & Public Health; Original Article; Postoperative period; Radiation therapy; Risk assessment; Surgical Oncology; Thoracic Surgery; Throat surgery
• ISSN: 1612-9059; 1612-9067
• DOI: 10.1007/s10388-013-0369-5

Background Postoperative morbidity after esophagectomy for esophageal cancer is still frequent. Tools for prediction of postoperative complications have been sought, with the estimation of physiologic ability and surgical stress (E-PASS) scoring system being one of the candidates. The aim of this study was to determine the usefulness of the E-PASS system for risk assessment of esophagectomy. Methods The clinical courses of 308 patients who underwent elective subtotal esophagectomy with lymph node dissection for esophageal cancer were analyzed. The incidence and severity of complication and influence of preoperative therapy were investigated using the E-PASS system. Results The incidence of any complication was as high as 42.2 %. The frequency of severe and critical complications was 13.0 and 6.8 %, respectively. The E-PASS system could estimate the incidence and severity of complications. Patients with a comprehensive risk score (CRS) >0.9 had a significantly higher probability of incidence of severe or critical complications. The incidence of complication and the CRS increased linearly according to preoperative treatment in the following order: no preoperative treatment