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@article{Klevebro:2019:10.1245/s10434-019-07478-6,
author = {Klevebro, F and Elliott, JA and Slaman, A and Vermeulen, BD and Kamiya, S and Rosman, C and Gisbertz, SS and Boshier, PR and Reynolds, JV and Rouvelas, I and Hanna, GB and van, Berge Henegouwen MI and Markar, SR},
doi = {10.1245/s10434-019-07478-6},
journal = {Annals of Surgical Oncology},
pages = {2864--2873},
title = {Cardiorespiratory comorbidity and postoperative complications following esophagectomy: a European multicenter cohort study},
url = {http://dx.doi.org/10.1245/s10434-019-07478-6},
volume = {26},
year = {2019}
}

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TY  - JOUR
AB  - BACKGROUND: The impact of cardiorespiratory comorbidity on operative outcomes after esophagectomy remains controversial. This study investigated the effect of cardiorespiratory comorbidity on postoperative complications for patients treated for esophageal or gastroesophageal junction cancer. PATIENTS AND METHODS: A European multicenter cohort study from five high-volume esophageal cancer centers including patients treated between 2010 and 2017 was conducted. The effect of cardiorespiratory comorbidity and respiratory function upon postoperative outcomes was assessed. RESULTS: In total 1590 patients from five centers were included; 274 (17.2%) had respiratory comorbidity, and 468 (29.4%) had cardiac comorbidity. Respiratory comorbidity was associated with increased risk of overall postoperative complications, anastomotic leak, pulmonary complications, pneumonia, increased Clavien-Dindo score, and critical care and hospital length of stay. After neoadjuvant chemoradiotherapy, respiratory comorbidity was associated with increased risk of anastomotic leak [odds ratio (OR) 1.83, 95% confidence interval (CI) 1.11-3.04], pneumonia (OR 1.65, 95% CI 1.10-2.47), and any pulmonary complication (OR 1.52, 95% CI 1.04-2.22), an effect which was not observed following neoadjuvant chemotherapy or surgery alone. Cardiac comorbidity was associated with increased risk of cardiovascular and pulmonary complications, respiratory failure, and Clavien-Dindo score ≥ IIIa. Among all patients, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio > 70% was associated with reduced risk of overall postoperative complications, cardiovascular complications, atrial fibrillation, pulmonary complications, and pneumonia. CONCLUSIONS: The results of this study suggest that cardiorespiratory comorbidity and impaired pulmonary function are associated with increased risk of postoperative complications after esophagectomy performed in high-volume E
AU  - Klevebro,F
AU  - Elliott,JA
AU  - Slaman,A
AU  - Vermeulen,BD
AU  - Kamiya,S
AU  - Rosman,C
AU  - Gisbertz,SS
AU  - Boshier,PR
AU  - Reynolds,JV
AU  - Rouvelas,I
AU  - Hanna,GB
AU  - van,Berge Henegouwen MI
AU  - Markar,SR
DO  - 10.1245/s10434-019-07478-6
EP  - 2873
PY  - 2019///
SN  - 1068-9265
SP  - 2864
TI  - Cardiorespiratory comorbidity and postoperative complications following esophagectomy: a European multicenter cohort study
T2  - Annals of Surgical Oncology
UR  - http://dx.doi.org/10.1245/s10434-019-07478-6
UR  - https://www.ncbi.nlm.nih.gov/pubmed/31183640
UR  - https://link.springer.com/article/10.1245%2Fs10434-019-07478-6
UR  - http://hdl.handle.net/10044/1/71393
VL  - 26
ER  -

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