Evidence map›Paper›PMID 42005718›Full record

ArticleClinical and translational radiation oncology2026

The complication sum score: A Delphi-based approach to summarize treatment related complications for esophageal cancer.

M L Frederiks, M Berbée, B P L Wijnhoven, E Schuit, P S N van Rossum, G J Meijer, S Mook, J J Nuyttens, H Rütten, M D den Hartogh and 5 more

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Article in Clinical and translational radiation oncology, 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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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

M L FrederiksDepartment of Radiation Oncology, University Medical Center Groningen, Groningen, the Netherlands.
M BerbéeDepartment of Radiation Oncology (MAASTRO), Maastro Clinic, Maastricht, the Netherlands.
B P L WijnhovenDepartment of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, the Netherlands.
E SchuitDepartment of Epidemiology & Health Economics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
P S N van RossumDepartment of Radiation Oncology, Amsterdam UMC (VUmc Amsterdam), the Netherlands.
G J MeijerDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
S MookDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
J J NuyttensDepartment of Radiation Oncology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
H RüttenDepartment of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
M D den HartoghRadiotherapiegroep, Arnhem/Deventer, the Netherlands.
B van EttenDepartment of Surgery, University Medical Center Groningen, Groningen, the Netherlands.
J A LangendijkDepartment of Radiation Oncology, University Medical Center Groningen, Groningen, the Netherlands.
H W M van LaarhovenAmsterdam UMC, location University of Amsterdam, Department of Medical Oncology, De Boelelaan 1017, 1081 HV Amsterdam, the Netherlands.
C T MuijsDepartment of Radiation Oncology, University Medical Center Groningen, Groningen, the Netherlands.
MODELS consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and purpose: Prevention of treatment-related complications remains a major challenge in esophageal cancer (EC) patients undergoing neoadjuvant chemoradiotherapy (nCRT) ± surgery. A single measure, reflecting the total complication burden, may provide a clear overall picture of patient burden and enables a direct comparison of alternative treatment strategies. We developed a Complication Sum Score (CSS) to quantify symptomatic complications. Materials and methods: A Delphi consensus procedure was used to develop the CCS using the expertise of health professionals to assess the impact of a spectrum of complications. The impact of each complication was scored on a 0-100 scale. Consensus for these scores was defined as an interquartile range ≤ 20. The association between the CSS and hospital/ICU stay, overall survival (OS) at 1 year and quality of life (QoL) was assessed in a multicenter dataset of patients with EC, using multivariable (logistic) regression analysis, correcting for possible confounders. Results: Forty-five experts completed the two-round Delphi procedure. Consensus was reached for all (36) complications. In 1225 patients, that underwent nCRT and esophagectomy, a higher CSS was significantly associated with a longer hospital (coefficient = 0.43[0.38-0.48], p < 0.01) and ICU stay (coefficient = 0.23[0.19-0.26], p < 0.01), and a worse OS (odds ratio = 1.005[1.004-1.006], p < 0.01). Among the patients that completed a QoL questionnaire after surgery (n = 98) an increased CSS was associated with worse QoL (coefficient = -0.24[-0.01-0.49], p = 0.06). Conclusion: The CSS offers a comprehensive tool to quantify treatment-related complications in a single score in EC patients that receive nCRT followed by surgical resection.

Indexed as

Delphi consensusEsophageal cancerNeoadjuvant chemoradiotherapyNormal tissue complication probabilityTreatment-related toxicity

Identifiers

PMID42005718
PMCPMC13087729

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