Postoperative Complications Do Not Affect Long-Term Outcome in Esophageal Cancer Patients

• Published in: World journal of surgery 2014-10, Vol.38 (10), p.2652-2661
• Main Authors: Lindner, Kirsten, Fritz, Mathias, Haane, Christina, Senninger, Norbert, Palmes, Daniel, Hummel, Richard
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adenocarcinoma - mortality; Adenocarcinoma - secondary; Adenocarcinoma - therapy; Adult; Aged; Aged, 80 and over; Anastomotic Leak - etiology; Anastomotic Leak - mortality; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - therapy; Cardiac Surgery; Chemoradiotherapy, Adjuvant; Chemotherapy, Adjuvant; Esophageal Cancer; Esophageal Cancer Patient; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - therapy; Esophagectomy - adverse effects; Female; General Surgery; Humans; Lymphatic Metastasis; Male; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Pulmonary Complication; Respiratory Tract Diseases - etiology; Respiratory Tract Diseases - mortality; Retrospective Studies; Sex Factors; Squamous Cell Carcinoma; Squamous Cell Carcinoma Patient; Surgery; Survival Rate; Thoracic Surgery; Time Factors; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-014-2590-3

Background As esophagectomy is associated with a considerable complication rate, the aim of this study was to assess the impact of postoperative complications and neoadjuvant treatment on long-term outcome of adenocarcinoma (EAC) and squamous cell carcinoma (SCC) patients. Methods Altogether, 134 patients undergoing transthoracic esophagectomy between 2005 and 2010 with intrathoracic stapler anastomosis were included in the study. Postoperative complications were allocated into three main categories: overall complications, acute anastomotic insufficiency, and pulmonary complications. Data were collected prospectively and reviewed retrospectively for the purpose of this study. Results SCC patients suffered significantly more often from overall and pulmonary complications (SCC vs. EAC: overall complications 67 vs. 45 %, p  = 0.044; pulmonary complications 56 vs. 34 %, p  = 0.049). The anastomotic insufficiency rates did not differ significantly (SCC 11%, EAC 15%, p  = 0.69). Long-term survival of EAC and SCC patients was not affected by perioperative ( overall/pulmonary) complications or by the occurrence of anastomotic insufficiency. Also, neoadjuvant treatment did not influence the incidence of complications or long-term survival. Conclusions This is the first time the patient population of a center experienced with esophageal cancer surgery was assessed for the occurrence of general and esophageal cancer surgery-specific perioperative complications. Our results indicated that these complications did not affect long-term survival of EAC and SCC patients. Our data support the hypothesis that neoadjuvant treatment might not affect the incidence of perioperative complications or long-term survival after treatment of these tumor subtypes.