| Title |
Esophageal Cancer Surgery for Patients with Concomitant Liver Cirrhosis: A Single-Center Matched-Cohort Study
|
|---|---|
| Published in |
Annals of Surgical Oncology, October 2016
|
| DOI | 10.1245/s10434-016-5610-8 |
| Pubmed ID | |
| Authors |
Michele Valmasoni, Elisa Sefora Pierobon, Carlo Alberto De Pasqual, Gianpietro Zanchettin, Lucia Moletta, Renato Salvador, Mario Costantini, Alberto Ruol, Stefano Merigliano |
| Abstract |
Cirrhosis is a risk factor with nonhepatic surgery, but only three series regarding esophagectomy are reported. The Model for End-Stage Liver Disease (MELD) score has shown benefit in risk evaluation, but there is no experience regarding esophagectomy. This study aimed to compare the outcomes of surgery for esophageal cancer between cirrhotic and noncirrhotic patients and to evaluate whether the MELD score has a prognostic value for risk stratification. From the authors' esophageal cancer database, they selected all the patients with concomitant cirrhosis who underwent surgery with curative intent and a matched cohort of patients without cirrhosis. The preoperative data included demographics, medical history, blood work, American Society of Anesthesiologists (ASA) score, Child-Turcotte-Pugh (CTP) score, and MELD score. The operative data included type of surgery, radicality, operative time, and blood loss. The postoperative data included hemoderivatives, 90-day morbidity and mortality rates, lab works, and hospital length of stay. The cirrhotic patients were further divided and analyzed according to a MELD score cutoff of 9. Of 3445 esophageal cancer patients, 73 cirrhotic patients underwent surgery. Their 90-day morbidity and mortality rates were higher than those for 146 noncirrhotic patients. The cirrhotic patients also had more respiratory events (p = 0.013) and infections (p = 0.005). The anastomotic complications among the cirrhotic patients were significantly more severe (p = 0.046). No difference in 5-year survival rates was registered. Stratification according to the MELD score showed that patients with a MELD score higher than 9 had a significantly worse postoperative course (5-year survival: p = 0.004). The patients with a MELD score of 9 or lower showed an outcome similar to that of the noncirrhotic patients. Liver cirrhosis is not an absolute contraindication to esophagectomy. The MELD score can be applicable for esophagectomy risk assessment for cirrhotic patients. |
X Demographics
The data shown below were collected from the profiles of 5 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Portugal | 1 | 20% |
| Canada | 1 | 20% |
| Unknown | 3 | 60% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 40% |
| Scientists | 2 | 40% |
| Science communicators (journalists, bloggers, editors) | 1 | 20% |
Mendeley readers
The data shown below were compiled from readership statistics for 36 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 36 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 5 | 14% |
| Researcher | 4 | 11% |
| Other | 3 | 8% |
| Professor | 3 | 8% |
| Student > Bachelor | 3 | 8% |
| Other | 11 | 31% |
| Unknown | 7 | 19% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 24 | 67% |
| Philosophy | 1 | 3% |
| Nursing and Health Professions | 1 | 3% |
| Arts and Humanities | 1 | 3% |
| Unknown | 9 | 25% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 March 2017.
All research outputs
#12,967,131
of 22,890,496 outputs
Outputs from Annals of Surgical Oncology
#3,601
of 6,493 outputs
Outputs of similar age
#159,585
of 319,862 outputs
Outputs of similar age from Annals of Surgical Oncology
#45
of 98 outputs
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