Impact of anastomotic leak vs pneumonia on Long-term overall and disease-free survival after transthoracic esophagectomy for cancer
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Le résumé fourni par la source
Background: Pneumonia and anastomotic leak are the 2 most feared complications after transthoracic esophagectomy for cancer. We have recently demonstrated that both complications have the same impact on in-hospital mortality, but their influence on long-term overall and disease-free survival is merely unknown. Aim of the study was to explore this aspect with a large international, multicentric, retrospective population-based analysis. Methods: After IRB-Approval, the prospectively maintained databases of 5 tertiary centers (4 in Europe and 1 in the USA) were quired for patients who underwent transthoracic esophagectomy for cancer between 2007 and 2024. Perioperative complications were assessed and the impact of pneumonia and anastomotic leak on long-term overall and disease-free survival was analyzed with the Kaplan-Meier method. Results: 1452 patients were included [1197 men (82.4%) and 255 women (17.6%)]. Mean age was 64.5 years. Anastomotic leak was registered in 172 patients (11.8%), while pneumonia in 219 (15.1%). Of these, 52 subjects (3.6%) had both complications. Long-term follow-up was available for 1343 patients. Kaplan-Meier analysis showed that patients who suffered only an anastomotic leak had better overall survival than patients who suffered only pneumonia (3y OS 66.5% vs. 51.9%; 5y OS 61.5% vs. 46.7%). The respective log-rank test comparing the two Kaplan-Meier curves was significant at the 5% level (p=0.008). In contrast, patients who suffered only an anastomotic leak had worse disease-free survival than patients who suffered only pneumonia (3y DFS 55.2% vs. 68.7%; 5y DFS 39.2% vs. 61.8%). The respective log-rank test was highly significant (p<0.001). Conclusions: Anastomotic leak and pneumonia are both dangerous complications after esophagectomy for cancer. While pneumonia seems to be a more dangerous complication when compared to anastomotic leak with regard to long-term overall-survival, the picture is inverse with respect to disease-free survival. Publication History Article published online: 04 September 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Impact of anastomotic leak vs pneumonia on Long-term overall and disease-free survival after transthoracic esophagectomy for cancer
- Date Crossref
- 01/09/2025
- Éditeur
- Georg Thieme Verlag KG
- Type
- proceedings-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Paracelsus Medizinische Privatuniversität pays non établi dans la noticeUniversité ou école supérieure
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Paracelsus Medical University pays non établi dans la noticeUniversité ou école supérieure
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Salzburger Landeskliniken pays non établi dans la noticeÉtablissement de santé
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University of Padua pays non établi dans la noticeUniversité ou école supérieure
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St. Joseph's Hospital and Medical Center pays non établi dans la noticeÉtablissement de santé
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IRCCS Policlinico San Donato pays non établi dans la noticeÉtablissement de santé
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Helios Klinikum Erfurt pays non établi dans la noticeÉtablissement de santé
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University of Padova – Italy pays non établi dans la noticeUniversité ou école supérieure
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Helios Clinic Erfurt pays non établi dans la noticeÉtablissement de santé
Paracelsus Medizinische Privatuniversität, Paracelsus Medical University et Salzburger Landeskliniken, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.