[Prognostic factors for resectable esophageal cancer].
Objective was to evaluate prognostic factors influencing the postoperative mortality after esophagectomy.


METHODS
The results of surgical treatment of 106 patients suffering from esophageal cancer were analyzed retrospectively. The presurgical risk factors in the surviving patients (group I, n=94) and in those patients, who died within the postoperative period (group II, n=12), were compared. The following indicators were analyzed: patients' age, body mass index, preoperative loss of body mass, tumor location, type and duration of operation, amount of blood transfused, ECG changes, changes in the lungs visible on chest X-ray, and spirometry indices. We examined the volume of forced expiration within the first second (FEV1), forced expiratory vital capacity (FVC), peak expiratory flow (PEF), Gaensler index (FEV1/FVC), Tiffeneu index (FEV1/VC) and amount of PaCO(2)in arterial blood.


RESULTS
Postoperative mortality was 11.3%. The following statistically reliable differences in the indices of group I and group II patients were established: FEV1 (82.3% and 65.4%), Gaensler index (75.2% and 68.5%), PaCO(2)(37.4 mmHg ir 42 mmHg), radiographic changes in the lings (13.6%l and 61.2%), loss of body mass within the preoperative period (11.2% and 18.3%), lower albumin values (39.9 g/l and 30.5 g/l) and tumor localization within the upper third of the esophagus (22% and 68.8%). The leak of anastomosis - 11.8% and 82.8%.


CONCLUSIONS
The postoperative mortality after esophagectomy mostly depends on the status of pulmonary function during the postoperative period, inadequate nutrition during the preoperative period and tumor localization in the upper third of the esophagus. Main complications after esophagectomy are pulmonary insufficiency and leak of anastomosis.
Zurauskas
Aleksas
A
Institute of Oncology, Vilnius University, Lithuania. aleksas_z@mail.lt
Miliauskas
Povilas
P
Tikuisis
Renatas
R
Cicenas
Saulius
S
Stratilatovas
Eugenijus
E
Sangaila
Egidijus
E
Ostapenko
Valerijus
V
D000367:Age Factors; D001803:Blood Transfusion; D015992:Body Mass Index; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors