Madhan K Kuppusamy1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36, Donald E Low1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36. 1. Agaplesion Markus Krankenhaus, Frankfurt, Germany. 2. Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands. 3. Cambridge Oesophago-Gastric Centre, Addenbrookes Hospital, Cambridge, UK. 4. Claude Huriez University Hospital, Lille, France; Erasmus Medical Center, Rotterdam. 5. Netherlands; Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA. 6. Guy's & St Thomas' NHS Foundation Trust, London, UK. 7. Hirslanden Medical Center, Zürich, Switzerland; Hôpital Nord, Aix-Marseille Université, Marseille, France. 8. Hospital Universitario del Mar, Barcelona, Spain. 9. Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. 10. Katholieke Universiteit Leuven, Leuven, Belgium; Keio University, Tokyo, Japan. 11. Massachusetts General Hospital, Boston, MA. 12. MD Anderson Cancer Center, Houston, TX. 13. Memorial Sloan Kettering Cancer Center, New York City, NY. 14. National University Hospital, Singapore, Singapore. 15. Northern Oesophagogastric Cancer Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK. 16. Nottingham University Hospitals NHS Trust, Nottingham, UK. 17. Odense University Hospital, Odense, Denmark. 18. Oregon Health and Science University, Portland, OR. 19. Oxford University Hospitals NHS Foundation Trust, Oxford, UK. 20. Princess Alexandra Hospital, University of Queensland, Brisbane, Australia. 21. Queen Elizabeth Hospital University of Birmingham, Birmingham, UK. 22. Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China. 23. Royal Victoria Hospital, Belfast, Northern Ireland. 24. Sichuan Cancer Hospital & Institute, Chengdu, China. 25. St. James's Hospital Trinity College, Dublin, Ireland. 26. Tata Memorial Center, Mumbai, India. 27. The University of Chicago Medicine, Chicago, IL. 28. Toronto General Hospital, Toronto, Canada. 29. University Hospital of Cologne, Cologne, Germany. 30. University Hospital Southampton NHS Foundation Trust, Southampton, UK. 31. University Medical Center, Utrecht, Netherlands. 32. University of Michigan Health System, Ann Arbor, MI. 33. University of São Paulo School of Medicine, São Paulo, Brazil. 34. University of Verona, Verona, Italy. 35. Virginia Mason Medical Center, Seattle, WA. 36. Vita-Salute San Raffaele University, Milan, Italy.
Abstract
OBJECTIVE: This study aims to verify the utility of international online datasets to benchmark and monitor treatment and outcomes in major oncologic procedures. BACKGROUND: The Esophageal Complication Consensus Group (ECCG) has standardized the reporting of complications after esophagectomy within the web-based Esodata.org database. This study will utilize the Esodata dataset to update contemporary outcomes and to monitor trends in practice in an era of rapid technical change. METHODS: This observational study, based on a prospectively developed specific database, updates esophagectomy outcomes collected between 2015 and 2018. Evolution in patient and operative demographics, treatment, complications, and quality outcome measures were compared between patients undergoing surgery in 2015 to 2016 and 2017 to 2018. RESULTS: Between 2015 and 2018, 6022 esophagectomies from 39 centers were entered into Esodata. Most patients were male (78.3%) with median age 63. Patients having minimally invasive esophagectomy constituted 3177 (52.8%), a chest anastomosis 3838 (63.7%), neoadjuvant chemoradiotherapy 2834 (48.7%), and R0 resections 5441 (93.5%). For quality measures, 30- and 90-day mortality was 2.0% and 4.5%, readmissions 9.7%, transfusions 12%, escalation in care 22.1%, and discharge home 89.4%. Trends in quality measures between 2015 and 2016 (2407 patients) and 2017 and 2018 (3318 patients) demonstrated significant (P < 0.05) improvements in readmissions 11.1% to 8.5%, blood transfusions 14.3% to 10.2%, and escalation in care from 24.5% to 20% A significantly (P < 0.05) reduced incidence in pneumonia (15.3%-12.8%) and renal failure (1.0%-0.4%) was observed. Anastomotic leak rates increased from 11.7% to 13.1%, whereas leaks requiring surgery decreased 3.3% and 3.0%, respectively. CONCLUSIONS: The Esodata database provides a valuable resource for assessing contemporary international outcomes. This study highlights an increased application of minimally invasive approaches, a high percentage of complications, improvements in pneumonia and key quality metrics, but with anastomotic leak rates still >10%.
OBJECTIVE: This study aims to verify the utility of international online datasets to benchmark and monitor treatment and outcomes in major oncologic procedures. BACKGROUND: The Esophageal Complication Consensus Group (ECCG) has standardized the reporting of complications after esophagectomy within the web-based Esodata.org database. This study will utilize the Esodata dataset to update contemporary outcomes and to monitor trends in practice in an era of rapid technical change. METHODS: This observational study, based on a prospectively developed specific database, updates esophagectomy outcomes collected between 2015 and 2018. Evolution in patient and operative demographics, treatment, complications, and quality outcome measures were compared between patients undergoing surgery in 2015 to 2016 and 2017 to 2018. RESULTS: Between 2015 and 2018, 6022 esophagectomies from 39 centers were entered into Esodata. Most patients were male (78.3%) with median age 63. Patients having minimally invasive esophagectomy constituted 3177 (52.8%), a chest anastomosis 3838 (63.7%), neoadjuvant chemoradiotherapy 2834 (48.7%), and R0 resections 5441 (93.5%). For quality measures, 30- and 90-day mortality was 2.0% and 4.5%, readmissions 9.7%, transfusions 12%, escalation in care 22.1%, and discharge home 89.4%. Trends in quality measures between 2015 and 2016 (2407 patients) and 2017 and 2018 (3318 patients) demonstrated significant (P < 0.05) improvements in readmissions 11.1% to 8.5%, blood transfusions 14.3% to 10.2%, and escalation in care from 24.5% to 20% A significantly (P < 0.05) reduced incidence in pneumonia (15.3%-12.8%) and renal failure (1.0%-0.4%) was observed. Anastomotic leak rates increased from 11.7% to 13.1%, whereas leaks requiring surgery decreased 3.3% and 3.0%, respectively. CONCLUSIONS: The Esodata database provides a valuable resource for assessing contemporary international outcomes. This study highlights an increased application of minimally invasive approaches, a high percentage of complications, improvements in pneumonia and key quality metrics, but with anastomotic leak rates still >10%.
Authors: Benjamin Babic; Rabi R Datta; Wolfgang Schröder; Lars M Schiffmann; Thomas Schmidt; Christiane J Bruns; Hans F Fuchs Journal: Chirurg Date: 2021-08-27 Impact factor: 0.955
Authors: Alexander B J Borgstein; Stefanie Brunner; Wolfgang Schröder; Mark I van Berge Henegouwen; Masaru Hayami; Johnny Moons; Hans Fuchs; Wietse J Eshuis; Suzanne S Gisbertz; Christiane J Bruns; Philippe Nafteux; Magnus Nilsson Journal: Ann Surg Oncol Date: 2021-04-08 Impact factor: 5.344