Esophageal Cancer Patients Have a High Incidence of Severe Periodontitis and Preoperative Dental Care Reduces the Likelihood of Severe Pneumonia after Esophagectomy.
BACKGROUND
Poor oral health is a risk factor for causing upper aerodigestive tract tumors, including esophageal cancer. Our aim was to determine the periodontitis rate in our cohort of esophageal cancer patients. We also analyzed whether preoperative dental examination and care reduces the likelihood of severe pneumonia after esophagectomy.


METHODS
Between 2003 and 2014, 529 esophageal cancer patients received esophagectomy at Akita University Hospital. We studied 232 patients who had preoperative dental examinations and care (dental care group) retrospectively and assessed the severity of their periodontitis. The dental care group was compared to 297 patients who did not have preoperative dental care (control group) with respect to the incidence of severe pneumonia after esophagectomy.


RESULTS
Ninety-one patients (39.2%) in the dental care group were diagnosed with slight periodontitis and 69 (29.7%) were diagnosed with severe periodontitis. Among all the patients, 69 patients (13.0%) were diagnosed with grade 3B postoperative severe pneumonia. The dental care group had a significantly lower incidence of severe pneumonia than the control group. Moreover, multivariable logistic regression analysis revealed that anastomotic leakage, preoperative dental care, gender and %VC were correlated significantly with the occurrence of postoperative severe pneumonia.


CONCLUSIONS
Preoperative dental examination and care by a dentist are essential to reduce the likelihood of postoperative severe pneumonia in esophageal cancer patients.
Department of Thoracic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
Yusuke
Y
Sato
Satoru
S
Motoyama
Hiroshi
H
Takano
Akira
A
Nakata
Jiajia
J
Liu
Daiki
D
Harimaya
Naoto
N
Todo
Kei
K
Yoshino
Tomohiko
T
Sasaki
Akiyuki
A
Wakita
Yuta
Y
Kawakita
Kazuhiro
K
Imai
Hajime
H
Saito
Masayuki
M
Fukuda
Yoshihiro
Y
Minamiya
D000368:Aged; D003729:Dental Care; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications*; D011014:Pneumonia / Q000209:etiology* / Q000517:prevention & control; D011300:Preoperative Care; D065840:Protective Factors; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014081:Tooth Extraction