ArticleEsophagus : official journal of the Japan Esophageal Society2026
The Geriatric Nutritional Risk Index and pulmonary function predict non-esophageal cancer-related mortality after esophagectomy.
Article in Esophagus : official journal of the Japan Esophageal Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNumerous studies have investigated prognostic factors for esophageal cancer after curative surgery; however, little is known about the risk factors for non-esophageal cancer-related death. This study identifies predictors of non-esophageal cancer mortality following esophagectomy.
methodsWe retrospectively analyzed 398 patients who underwent thoracic subtotal esophagectomy for thoracic esophageal or esophagogastric junction cancer from 2009 to 2022. Patients with non-curative resection, special histology, or in-hospital death were excluded. Cause-specific Cox regression was used to assess predictors of non-esophageal cancer-related death. The cumulative incidence function (CIF) was estimated while taking competing risks into account, and Gray's test was applied for group comparisons.
resultsDuring follow-up, 181 patients died: 118 from esophageal cancer, and 63 from other causes. Non-esophageal cancer-related deaths were due to respiratory diseases (n = 23), second cancers (n = 15), and other causes (n = 25). Patients who died of non-esophageal cancer-related causes had lower Geriatric Nutritional Risk Index (GNRI) and body mass index, were older, and more frequently had hypertension compared with the other groups. CIF analysis revealed that non-esophageal cancer-related deaths increased gradually over 10 years and beyond, while respiratory-related deaths tended to occur within the first 10 years. Multivariable analysis revealed that age, percent vital capacity (%VC), and GNRI were independent predictors.
conclusionsLower GNRI and %VC were independent predictors of non-esophageal cancer-related death among patients undergoing curative esophagectomy for esophageal cancer. Assessment of preoperative nutritional and pulmonary status may help identify vulnerable patients and guide postoperative management and supportive care.
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