Abstract
Early detection of anastomotic leakage (AL) after oesophageal resection for malignancy is crucial. This retrospective study validates a risk score, predicting AL, which includes C-reactive protein, albumin and white cell count in patients undergoing oesophageal resection between 2003 and 2014. For validation of the NUn score a receiver operating characteristic (ROC) curve is estimated. Area under the ROC curve (AUC) is reported with 95% confidence interval (CI). Among 258 patients (79.5% male) 32 patients showed signs of anastomotic leakage (12.4%). NUn score in our data has a median of 9.3 (range 6.2–17.6). The odds ratio for AL was 1.31 (CI 1.03–1.67; p = 0.028). AUC for AL was 0.59 (CI 0.47–0.72). Using the original cutoff value of 10, the sensitivity was 45.2% an the specificity was 73.8%. This results in a positive predictive value of 19.4% and a negative predictive value of 90.6%. The proportion of variation in AL occurrence, which is explained by the NUn score, was 2.5% (PEV = 0.025). This study provides evidence for an external validation of a simple risk score for AL after oesophageal resection. In this cohort, the NUn score is not useful due to its poor discrimination.
Highlights
Surgery still remains crucial in the treatment of oesophageal cancer (EC)[1,2,3]
This study provides evidence for an external validation of a simple score for risk assessment for anastomotic leakage after oesophageal resection
With each point on the NUn score the odds for anastomotic leakage (AL) are increased on average by 31%
Summary
Surgery still remains crucial in the treatment of oesophageal cancer (EC)[1,2,3]. Due to improvements in the perioperative treatment, patient selection and technical advances, morbidity and mortality-rates could be significantly reduced over the last years. In 2012, Noble and Underwood (NUn) introduced a novel score describing postoperative assessment and detection of ALs7. The attempt to validate this score by Findlay and others, analysing a comparable cohort, showed that they were unable to replicate the findings of the original publication[8]. Major limitation of this validation attempt was that laboratory testing did not state CRP values above 156 ml/l. A crucial variable of the NUn score made a minute replication impossible. Aim of our study was to attempt validation of the NUn score and screen for other prognostic factors for morbidity and particular for AL after oesophageal resection
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
