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An original scoring system for predicting postoperative morbidity after esophagectomy for esophageal cancer

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Abstract

Purpose

Postoperative morbidity remains common after esophagectomy. There are currently few tools that can be used to estimate the incidence of complications. This study aimed to create a novel scoring system for predicting postoperative morbidity.

Methods

A total of 365 patients who underwent elective esophagectomy with two- or three-field lymphadenectomy for esophageal cancer were retrospectively analyzed. Patients were divided into development (n = 250) and validation datasets (n = 115). A scoring system was established by specifying the expected morbidity incidence values for all independent predictors in the development dataset, after which, the reproducibility was confirmed in the validation dataset.

Results

The incidence of any morbidity was 44.7 %. Male sex, severe emaciation (body mass index <18), a lower performance status (grade 1 or 2), operation ≥540 min and massive bleeding (blood loss/body weight ≥20) were independent predictors of postoperative morbidity. The total of all predictive scores was calculated. The incidence of any morbidity and of severe morbidity (Clavien–Dindo classification ≥IIIb) significantly correlated with the score after dividing the scores into three groups (≤8, 10 and 11 and ≥13). This finding was also confirmed in the validation dataset.

Conclusion

The current scoring system is considered to be useful for predicting postoperative morbidity after esophagectomy.

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Conflict of Interest

Naoya Yoshida and co-authors have no conflicts of interest to declare in association with this study.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan

    Naoya Yoshida, Yoshifumi Baba, Satoshi Ida, Takatsugu Ishimoto, Ryuichi Karashima, Shiro Iwagami, Yu Imamura, Yasuo Sakamoto, Yuji Miyamoto & Hideo Baba

  2. Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Masayuki Watanabe

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  1. Naoya Yoshida
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  2. Yoshifumi Baba
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  3. Masayuki Watanabe
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  4. Satoshi Ida
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  5. Takatsugu Ishimoto
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  11. Hideo Baba
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Correspondence to Hideo Baba.

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Yoshida, N., Baba, Y., Watanabe, M. et al. An original scoring system for predicting postoperative morbidity after esophagectomy for esophageal cancer. Surg Today 45, 346–354 (2015). https://doi.org/10.1007/s00595-014-0958-5

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  • DOI: https://doi.org/10.1007/s00595-014-0958-5

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