• Annals of surgery · Mar 2017

    Prognostic Significance of Postoperative Complications After Curative Resection for Patients With Esophageal Squamous Cell Carcinoma.

    • Hiroshi Saeki, Satoshi Tsutsumi, Hirotada Tajiri, Takafumi Yukaya, Ryosuke Tsutsumi, Sho Nishimura, Yu Nakaji, Kensuke Kudou, Shingo Akiyama, Yuta Kasagi, Ryota Nakanishi, Yuichiro Nakashima, Masahiko Sugiyama, Kippei Ohgaki, Hideto Sonoda, Eiji Oki, and Yoshihiko Maehara.
    • Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
    • Ann. Surg. 2017 Mar 1; 265 (3): 527-533.

    ObjectiveThe objective of this study was to elucidate the impact of postoperative complications on long-term survival after curative resection for esophageal squamous cell carcinoma.BackgroundThe relation between postoperative complications and long-term survival after curative surgery for esophageal squamous cell carcinoma is controversial; thus, this issue should be resolved with a large-scale, well-designed study.MethodsClinicopathological features and survival of 580 consecutive patients who received curative resection for esophageal squamous cell carcinoma were investigated according to the development of postoperative pulmonary complications and anastomotic leakage.ResultsThe 5-year survival rates of patients with pStage 0, I, and II disease with postoperative complications (n = 116) were significantly poorer than those of patients without postoperative complications (n = 288) (overall 69.6% vs 46.9%, P < 0.0001; disease-specific; 76.7% vs 58.9%, P < 0.0022), whereas no differences were found in patients with pStage III and IV disease (n = 176). In the univariate and multivariate analyses for disease-specific survival, pT3, pT4, pN positivity, and development of postoperative complications were significant prognostic factors in all patients. Also, when the analysis was limited to the pStage 0, I, and II patients, development of postoperative complications, and pT3, pT4, and pN positivity, were found to be independent poor prognostic factors in multivariate analyses (hazard ratio: 1.56, 95% confidence interval, 1.01-2.41, P = 0.0476).ConclusionsThe development of postoperative complications is an independent disease-specific poor prognostic factor after curative resection for patients with less-advanced esophageal squamous cell carcinoma.

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