Radical surgery for esophageal cancer: our experience and analysis of risk factors for perioperative mortality

Abstract

Radical operative therapy for esophageal cancer is usually connected with a significant mortality and morbidity. Purpose of this study is analysis of potential risk factors for mortality after radical surgery for esophageal cancer and presentation of our experience with this kind of surgery. There were 65 patients undergone radical surgery for esophageal cancer from the June 2003 to the April 2004 in our University Hospital for Chest Diseases. We analyzed as mortality risk factors: sex, age, albumin, aspartate transaminase, alanine transaminase, gamma glutamyl transferase, creatinine, hemoglobin, leucocytes, fibrinogene, prothrombine time, activated partial thromboplastine time, forced expiratory volume in the first second, vital pulmonary capacity, diffusion capacity for carbon monoxide (all preoperative), duration of surgery, perioperative infused fluid volume, perioperative transfusion, duration and stay in ICU. In our study perioperative mortality was 15.38%. Incidence of complications: pulmonary 44.61%, cardiac 6.15%, and surgical 27.69%. There were no statistically significant differences between groups of patients connected with most of analyzed factors. The most important finding is positive correlation of level of gamma glutamyl transpherase with perioperative mortality (p=0.012 for gamma glutamyl transferase >38 U/L, and p=0.017 for gamma glutamyl transferase >76 U/L-Fishers 2x2 test). Among the analyzed factors, only factor of potential prognostic importance for patients undergoing radical surgery for esophageal cancer could be the level of gamma glutamyl transferase. Reference: 1. Liu JF, Watson DI, Devitt PG, et al. Risk factor analysis of post-operative mortality in oesophagectomy. Dis Esophagus 2000 ; 13(2): 130-135.