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Poster Display

1573 - The role of cardiovascular risk factors on postoperative course after esophageal cancer surgery

Date

08 Oct 2016

Session

Poster Display

Presenters

Denis Collet

Citation

Annals of Oncology (2016) 27 (6): 207-242. 10.1093/annonc/mdw371

Authors

D. Collet1, C. Gronnier1, G. Luc2, R. Chevalier2, E. Guinard3, K. Dantrem2, B. Meunier3

Author affiliations

  • 1 Department Of Oeso-gastric And Endocrine Surgery, Centre Magellan Hôpital Haut-Lévêque, 33600 Pessac - Bordeaux/FR
  • 2 Department Of Oeso-gastric And Endocrine Surgery, Centre Magellan Hôpital Haut-Lévêque, Bordeaux/FR
  • 3 Dpt Of Digestive Surgery, CHU de Pontchaillou, Rennes/FR
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Resources

Abstract 1573

Background

After an esophagectomy vascularization of the gastric conduit is provided only by the right gastric artery. It is admitted that the risk of anastomotic leakage (AL) is increased by a low blood supply. Patients with esophageal cancer have frequently an impaired cardiac function and/or a atherosclerotic vascular disease (AVD). No data has previously emerged from studies regarding the role of cardiovascular risk factors (CRF) in patients who developed anastomotic leakage (AL) after esophagectomy in curative intent. The main objective was to determine if CRF can predict AL after Ivor-Lewis procedure in patients with intrathoracic esophageal cancer (EC).

Methods

We performed a retrospective study including all 352 consecutive patients operated on for EC in a curative intent between 2004 and 2014 in 2 referral centers. Patients treated by Ivor-Lewis procedure were analyzed. Nine CRF were identified according international consensus. Dindo Clavien classification was used to define postoperative complication. Predictive factors of AL were analyzed by multivariable regression analysis.

Results

Among 292 patients with EC treated with Ivor-Lewis procedure, 271 (92.8%) patients had one or more CRF. The median age was 64 years [range, 33 – 85], with a male to female sex ratio of 4.4:1. Squamous cell carcinoma (SCC) was present in 141 (73.8%) patients. Among the 111 (38%) patients with postoperative complications, 39 (13.4%) patients developed anastomotic leakage, 15 (5.1%) developed necrosis of the gastric conduit. Others main complications were pneumonia (n = 37 patients, 12.7%), chylothorax (n = 13 patients, 4.5%) and hemorrhage (n = 7 patients, 2.4%). In multivariate analysis, transfusion (odd ratio: 3.030, 95% CI [1.545 – 5.952], p = 0.001) and CRF > 3 (odd ratio: 2.958, 95% CI [1.132 – 7.751], p = 0.027) were predictive factors of AL.

Conclusions

Patients with >3 CRF have a higher risk of AL after Ivor-Lewis procedure. Further studies should focus on how to improve postoperative outcomes in this population.

Clinical trial identification


Legal entity responsible for the study

CHU Bordeaux

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.

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