Evidence map›Paper›PMID 40751484›Full record

ArticleBJS open2025

Effects of postoperative complications in oesophageal cancer on survival, hospital outcomes, and long-term quality of life: retrospective cohort study.

Nerma Crnovrsanin, Stefan Giring, Antonia Oppel, Ingmar F Rompen, Sabine Schiefer, Nicolas Jorek, Thomas Schmidt, Beat P Müller-Stich, Leila Sisic, Henrik Nienhüser

Abstract read
In one paragraph

Article in BJS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Nerma CrnovrsaninDepartment of General, Abdominal and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.ORCID 0009-0006-0036-9897
Stefan GiringDepartment of General, Abdominal and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Antonia OppelDepartment of General, Abdominal and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Ingmar F RompenDepartment of General, Abdominal and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.ORCID 0000-0002-0257-1654
Sabine SchieferDepartment of General, Abdominal and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.ORCID 0000-0001-9430-8994
Nicolas JorekDepartment of General, Abdominal and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Thomas SchmidtDepartment of General, Abdominal, Thoracic and Transplantation Surgery, University Hospital Cologne, Cologne, Germany.ORCID 0000-0002-7166-3675
Beat P Müller-StichDepartment of Surgery, Clarunis University Center for Gastrointestinal and Liver Disease, University Hospital and St. Clare Hospital Basel, Basel, Switzerland.
Leila SisicDepartment of General, Abdominal and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.ORCID 0000-0003-1260-5771
Henrik NienhüserDepartment of General, Abdominal and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany.ORCID 0000-0002-0475-9538

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPostoperative complications pose a major challenge in oesophageal surgery, affecting survival, recovery, and healthcare resource utilization. The aim of this study was to quantify the proportional contribution of specific complications to survival and adverse outcomes and to evaluate their effects on long-term quality of life (QoL) in patients with oesophageal and gastro-oesophageal junction cancer.

methodsThis retrospective cohort study included patients with oesophageal or gastro-oesophageal junction cancer who underwent surgery with curative intent between January 2010 and July 2022. Postoperative complications were categorized following Esophageal Complications Consensus Group guidelines. Population-attributable fractions (PAFs) were calculated to estimate the proportion of adverse outcomes and survival effects theoretically preventable if specific complications were avoided.

resultsIn 632 patients who underwent surgery, the most frequently observed complications were pulmonary (31%), infectious (29%), and gastrointestinal (24%). Pneumonia had the highest adjusted PAF for overall survival (8.3% after 2 years; 95% confidence interval (c.i.) 1.8 to 14.7), suggesting that preventing pneumonia could substantially reduce mortality. Anastomotic leak had the highest PAF for recurrence-free survival (6.6%; 95% c.i. 1.8 to 11.5) and was the complication most significantly contributing to reoperations (PAF 39.8%; 95% c.i. 22.2 to 52.1) and prolonged hospital stays (PAF 56.9%; 95% c.i. 46.8 to 66.2). Respiratory failure had the largest effect on 90-day mortality (PAF 53.5%; 95% c.i. 30.9 to 73.9). In contrast, no significant effect of complications on long-term QoL was observed.

conclusionThis study underscores the critical importance of targeted strategies to prevent postoperative complications, particularly pneumonia and anastomotic leakage, which contribute significantly to adverse outcomes such as reduced survival and prolonged hospital stays. Effective complication management may enhance oncological outcomes and optimize healthcare resource utilization.

Indexed as

Esophageal NeoplasmsEsophagectomyPostoperative ComplicationsQuality of LifeAgedAnastomotic LeakEsophagogastric JunctionFemaleHumansMaleMiddle AgedRetrospective Studies

Identifiers

PMID40751484
PMCPMC12317276

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.