Preoperative patient-related factors associated with prognosis after esophagectomy for esophageal cancer

Abstract

Background

To investigate the impact of the preoperative patient-related factors on survival after esophagectomy in patients with esophageal cancer.

Methods

We retrospectively reviewed 140 patients with esophageal cancer who underwent esophagectomy. Preoperative comorbidities, nutritional and inflammation status including the neutrophil to lymphocyte ratio and Glasgow prognostic score (GPS), and their pathological findings were analyzed to assess their relationships with prognosis.

Results

Univariate analysis demonstrated that a history of cardiovascular disease (CVD), a GPS of 1 or 2, lack of neo-adjuvant chemotherapy (NAC), no thoracoscopic esophagectomy, blood loss volume ≥255 ml, the number of lymph node metastasis (LNM) ≥2, lymphatic invasion, venous invasion, and residual cancer were associated with poor survival. Multivariate analysis revealed that a history of CVD [hazard ratio (HR) 2.129; 95% confidence interval (CI) 1.327–4.226; P = 0.041], a GPS of 1 or 2 (HR 3.232; 95% CI 1.516–6.437; P = 0.003), LNM ≥2 (HR 3.133; 95% CI 1.355–7.760; P = 0.007), and pathological residual cancer (HR 2.429; 95% CI 1.050–5.105; P = 0.039) were independently associated with poor survival, and NAC was associate with better survival (HR 0.289; 95% CI 0.118–0.667; P = 0.003).

Conclusions

Preoperative patient-related factors including a history of CVD and a GPS of 1 or 2 were predictors of poor prognosis after esophagectomy in patients with esophageal cancer.

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