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The effect of postoperative complications on survival of patients after minimally invasive esophagectomy for esophageal cancer

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Abstract

Background

Minimally invasive esophagectomy (MIE) has been shown to be a feasible technique for the treatment of esophageal cancer; however, its postoperative morbidity remains high. This retrospective study aimed to evaluate the effect of postoperative complications on long-term outcomes in patients who have undergone MIE for esophageal squamous cell carcinoma (ESCC).

Methods

This retrospective study enrolled patients who had undergone MIE for ESCC between September 2009 and November 2014; all procedures were performed by a single surgical team. Relevant patient characteristics and postoperative variables were collected and evaluated. The disease-free survival (DFS) and disease-specific survival (DSS) were determined by the Kaplan–Meier method, and compared by log-rank tests. Possible predictors of survival were subjected to univariate analysis and multivariate Cox proportional hazard regression analysis.

Results

In all, data on 214 patients with ESCC were analyzed, including 170 men and 44 women. All study subjects had undergone thoracoscopic or thoracoscopic–laparoscopic esophagectomy and cervical esophagogastric anastomosis. One hundred and thirty patients (60.7%) had postoperative complications (Grades 1–4). The overall DFS and DSS rates were 80.0 and 88.9% at 1 year, 48.6 and 54.2% at 3 years, and 43.2 and 43.5% at 5 years, respectively. Univariate analysis and multivariate Cox proportional hazard regression analysis showed that T stage, N stage, and tumor grade were independent prognostic factors for long-term survival; however, postoperative complications had no significant effect on the DFS or DSS of this patient cohort (log-rank test, p = 0.354 and 0.160, respectively).

Conclusions

Postoperative complications have no significant effect on long-term survival in patients who have undergone MIE for ESCC.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, People’s Republic of China

    Kun-Kun Li, Yin-Jian Wang, Xue-Hai Liu, Qun-You Tan, Yao-Guang Jiang & Wei Guo

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  1. Kun-Kun Li
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  2. Yin-Jian Wang
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  3. Xue-Hai Liu
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  5. Yao-Guang Jiang
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  6. Wei Guo
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Correspondence to Wei Guo.

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Disclosures

Kun-Kun Li, Yin-Jian Wang, Xue-Hai Liu, Qun-You Tan, Yao-Guang Jiang, and Wei Guo have no conflict of interest or financial ties to disclose.

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Li, KK., Wang, YJ., Liu, XH. et al. The effect of postoperative complications on survival of patients after minimally invasive esophagectomy for esophageal cancer. Surg Endosc 31, 3475–3482 (2017). https://doi.org/10.1007/s00464-016-5372-1

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  • DOI: https://doi.org/10.1007/s00464-016-5372-1

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