Induction Therapy Does Not Increase Surgical Morbidity After Esophagectomy for Cancer

• Published in: The Annals of thoracic surgery Vol. 78; no. 5; pp. 1783 - 1789
• Main Authors: Lin, Frank C.-F., Durkin, Amy E., Ferguson, Mark K.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-11-2004; Elsevier Science
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - radiotherapy; Adenocarcinoma - surgery; Adenocarcinoma - therapy; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Carcinoma, Squamous Cell - therapy; Chemotherapy, Adjuvant; Combined Modality Therapy; Esophageal Neoplasms - drug therapy; Esophageal Neoplasms - radiotherapy; Esophageal Neoplasms - surgery; Esophageal Neoplasms - therapy; Esophagectomy - statistics & numerical data; Female; Humans; Incidence; Male; Medical sciences; Middle Aged; Neoadjuvant Therapy - adverse effects; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Radiotherapy, Adjuvant; Remission Induction; Retrospective Studies; Risk Factors; Spirometry; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Surgery of the respiratory system; Treatment Outcome; 7; Prognosis; Respiratory disease; Surgery; Esophagectomy; Increase; Thorax; Malignant tumor; Epidemiology; Induction treatment; Morbidity; Esophagus
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2004.04.081

A complete pathological response after induction therapy for esophageal cancer offers survival benefits, but induction therapy may increase the risk of postoperative complications and mortality.
We performed a retrospective review of consecutive patients who underwent esophagectomy for esophageal cancer to identify preoperative predictors of complications and assess the possible influence of induction therapy on surgical outcomes.
Between 1988 and 2003, 170 esophagectomies were performed on our service; 95 (55.9%) underwent surgery alone and 75 (44.1%) received preoperative chemotherapy, 35 of whom also had preoperative radiation therapy. Based on multivariable regression analyses, independent covariates for complication categories included performance status (pulmonary, cardiovascular, total complications, and death), age (cardiovascular and other complications), and FEV
1% (pulmonary complications). Whether patients received induction therapy was unrelated to the incidence of postoperative complications.
We found no evidence that induction therapy adversely influences the incidence of postoperative morbidity or mortality after esophagectomy for cancer.