Medline: 10931059

British Journal of Surgery 87(8): 1106-1110, 2000.

Preoperative risk analysis in patients with adenocarcinoma or squamous cell carcinoma of the oesophagus.

Bollschweiler E, Schroder W, Holscher AH, et al.

Abstract:

Background:
The outcome after oesophagectomy depends not only on the surgical procedure itself but can be improved by the selection of patients based on a preoperative risk score.

Methods:
In order to compare the preoperative risk for different histological subtypes of oesophageal carcinoma, 221 patients with a squamous cell carcinoma (SCC) and 104 patients with an adenocarcinoma (AC) were enrolled in a prospective study. The preoperative assessment included socioeconomic status, alcohol and tobacco consumption, general and nutritional status, and pulmonary, cardiovascular, hepatic and renal function.

Results:
More patients with an SCC were 'blue collar' and with an AC were 'white collar' workers (P < 0.001). Alcohol and tobacco consumption was higher in patients with an SCC (P < 0.01 and P < 0.05 respectively). The preoperative forced expiratory volume, arterial partial pressure of oxygen and the aminopyrine breath test showed more severely compromised pulmonary and hepatic function in patients with an SCC (P < 0.05 for all variables). Some 50 per cent of patients with an AC were overweight with a higher body mass index (P < 0.001). More patients with an AC had severely impaired cardiac function (P < 0.01).

Conclusion:
Patients with SCC and AC of the oesophagus differed regarding their socioeconomic and preoperative risk factors for surgery.


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