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World Journal of Surgery

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12-01-2023 | Esophagus Resection | Original Scientific Report

Inflammatory and Nutritional Status Influences Outcomes of Minimally Invasive Esophagectomy

Authors: Shao-jun Xu, Ping-lan Wang, Chao Chen, Cheng-xiong You, Rui-qin Chen, Wen-wei Wu, Shu-chen Chen

Published in: World Journal of Surgery | Issue 4/2023

Abstract

Introduction

The potential association between severe postoperative complications (SPC) and the oncological outcomes of esophageal squamous cell carcinoma (ESCC) patients according to the different Naples Prognostic Score (NPS) of the inflammatory nutritional status after minimally invasive esophagectomy (MIE) is unclear.

Methods

Kaplan–Meier survival analysis was used to evaluate overall survival (OS) and disease-free survival (DFS) between with or without SPC (Clavien–Dindo grade ≥ III) in low NPS status (NPS = 0 or 1) and high NPS status (NPS = 2 or 3 or 4) patients. Cox multivariable analysis was carried out to analyze the various independent factors of OS and DFS, and a nomogram based on SPC was established.

Results

A total of 20.7% (125/604) ESCC patients developed SPC after MIE. Patients with SPC exhibited poor 5-year OS and DFS compared to those without SPC (all P < 0.001). Further analysis revealed that SPC significantly reduced OS and DFS in patients with high NPS status (all P < 0.001) but had little effect on the prognosis of patients with low NPS status (all P > 0.05). Multivariable Cox analysis revealed that SPC could be an independent influence indicator for OS and DFS in patients with high NPS status. Therefore, a novel nomogram combining SPC and tumor-node-metastasis (TNM) staging has been developed, which was found to be relatively more accurate in predicting OS and DFS than TNM staging alone.

Conclusion

Severe complications can adversely affect the long-term oncological outcome of ESCC patients with high systemic inflammatory response and malnutrition after MIE.

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Title: Inflammatory and Nutritional Status Influences Outcomes of Minimally Invasive Esophagectomy
Authors: Shao-jun Xu
Ping-lan Wang
Chao Chen
Cheng-xiong You
Rui-qin Chen
Wen-wei Wu
Shu-chen Chen
Publication date: 12-01-2023
Publisher: Springer International Publishing
Keywords: Esophagus Resection
Esophagus Resection
Published in: World Journal of Surgery / Issue 4/2023
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-023-06890-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Inflammatory and Nutritional Status Influences Outcomes of Minimally Invasive Esophagectomy

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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