462 DEFINING IMPACT OF PRE-OPERATIVE ANAEMIA ON SURVIVAL IN OESOPHAGOGASTRIC CANCER: A MULTI-INSTITUTIONAL ANALYSIS

Abstract

Abstract Growing interest surrounding pre-operative anaemia in patiens undergoing major surgery. However, no current evidence surrounding role of pre-operative anaemia on the post-operative outcomes and long-term survival following esophagectomy for esophageal cancers. This study aimed to evaluate morbidity and mortality according to pre-operative in patients undergoing esophagectomy for esophageal cancer. Methods Consecutive patients undergoing esophagectomy for esophageal cancers (adenocarcinoma or squamous cell carcinoma) between January 2000 and December 2018 at the Northern Oesophagogastric Unit were included from a prospectively maintained database. The main explanatory variable is pre-operative anaemia. Primary outcome was overall survival. Secondary outcomes include overall complications, anastomotic leaks and pulmonary complications. Results During the study period, 1148 patients underwent esophagectomy for cancer. Of these 7% (n = 78) had pre-operative anaemia. Median survival of patients with anaemia were similar to those without pre-operative anaemia (median: 67 vs 45, p = 0.1). On Cox multivariable regression analysis, pre-operative anaemia had no impact on long-term survival, even when stratified for oesophageal adenocarcinoma and squamous cell carcinoma. Rates of overall complications (71% vs 66%), anastomotic leaks (4% vs 8%) and pulmonary complications (19% vs 14%) were similar between the groups. Conclusion Contrary to published evidence in cardiothoracic and vascular surgery, pre-operative anaemia had no impact on long-term survival and post-operative outcomes for esophagectomy.