BACKGROUND: The Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA) have set standards in reporting outcomes after oesophagectomy. Reporting outcomes from selected high-volume centres or centralized national cancer programmes may not, however, be reflective of the true global prevalence of complications. This study aimed to compare complication rates after oesophagectomy from these existing sources with those of an unselected international cohort from the Oesophago-Gastric Anastomosis Audit (OGAA). METHODS: The OGAA was a prospective multicentre cohort study coordinated by the West Midlands Research Collaborative, and included patients undergoing oesophagectomy for oesophageal cancer between April and December 2018, with 90 days of follow-up. RESULTS: The OGAA study included 2247 oesophagectomies across 137 hospitals in 41 countries. Comparisons with the ECCG and DUCA found differences in baseline demographics between the three cohorts, including age, ASA grade, and rates of chronic pulmonary disease. The OGAA had the lowest rates of neoadjuvant treatment (OGAA 75.1 per cent, ECCG 78.9 per cent, DUCA 93.5 per cent; P < 0.001). DUCA exhibited the highest rates of minimally invasive surgery (OGAA 57.2 per cent, ECCG 47.9 per cent, DUCA 85.8 per cent; P < 0.001). Overall complication rates were similar in the three cohorts (OGAA 63.6 per cent, ECCG 59.0 per cent, DUCA 62.2 per cent), with no statistically significant difference in Clavien-Dindo grades (P = 0.752). However, a significant difference in 30-day mortality was observed, with DUCA reporting the lowest rate (OGAA 3.2 per cent, ECCG 2.4 per cent, DUCA 1.7 per cent; P = 0.013). CONCLUSION: Despite differences in rates of co-morbidities, oncological treatment strategies, and access to minimal-access surgery, overall complication rates were similar in the three cohorts.
BACKGROUND: The Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA) have set standards in reporting outcomes after oesophagectomy. Reporting outcomes from selected high-volume centres or centralized national cancer programmes may not, however, be reflective of the true global prevalence of complications. This study aimed to compare complication rates after oesophagectomy from these existing sources with those of an unselected international cohort from the Oesophago-Gastric Anastomosis Audit (OGAA). METHODS: The OGAA was a prospective multicentre cohort study coordinated by the West Midlands Research Collaborative, and included patients undergoing oesophagectomy for oesophageal cancer between April and December 2018, with 90 days of follow-up. RESULTS: The OGAA study included 2247 oesophagectomies across 137 hospitals in 41 countries. Comparisons with the ECCG and DUCA found differences in baseline demographics between the three cohorts, including age, ASA grade, and rates of chronic pulmonary disease. The OGAA had the lowest rates of neoadjuvant treatment (OGAA 75.1 per cent, ECCG 78.9 per cent, DUCA 93.5 per cent; P < 0.001). DUCA exhibited the highest rates of minimally invasive surgery (OGAA 57.2 per cent, ECCG 47.9 per cent, DUCA 85.8 per cent; P < 0.001). Overall complication rates were similar in the three cohorts (OGAA 63.6 per cent, ECCG 59.0 per cent, DUCA 62.2 per cent), with no statistically significant difference in Clavien-Dindo grades (P = 0.752). However, a significant difference in 30-day mortality was observed, with DUCA reporting the lowest rate (OGAA 3.2 per cent, ECCG 2.4 per cent, DUCA 1.7 per cent; P = 0.013). CONCLUSION: Despite differences in rates of co-morbidities, oncological treatment strategies, and access to minimal-access surgery, overall complication rates were similar in the three cohorts.
Authors: P van Hagen; M C C M Hulshof; J J B van Lanschot; E W Steyerberg; M I van Berge Henegouwen; B P L Wijnhoven; D J Richel; G A P Nieuwenhuijzen; G A P Hospers; J J Bonenkamp; M A Cuesta; R J B Blaisse; O R C Busch; F J W ten Kate; G-J Creemers; C J A Punt; J T M Plukker; H M W Verheul; E J Spillenaar Bilgen; H van Dekken; M J C van der Sangen; T Rozema; K Biermann; J C Beukema; A H M Piet; C M van Rij; J G Reinders; H W Tilanus; A van der Gaast Journal: N Engl J Med Date: 2012-05-31 Impact factor: 91.245
Authors: Leonie R van der Werf; Linde A D Busweiler; Johanna W van Sandick; Mark I van Berge Henegouwen; Bas P L Wijnhoven Journal: Ann Surg Date: 2020-06 Impact factor: 12.969
Authors: Bradley R Hall; Laura E Flores; Zachary S Parshall; Valerie K Shostrom; Chandrakanth Are; Bradley N Reames Journal: J Surg Oncol Date: 2019-07-10 Impact factor: 3.454
Authors: Maarten F J Seesing; Suzanne S Gisbertz; Lucas Goense; Richard van Hillegersberg; Hidde M Kroon; Sjoerd M Lagarde; Jelle P Ruurda; Annelijn E Slaman; Mark I van Berge Henegouwen; Bas P L Wijnhoven Journal: Ann Surg Date: 2017-11 Impact factor: 12.969
Authors: Sivesh K Kamarajah; Aaron Lin; Thahesh Tharmaraja; Yashvi Bharwada; James R Bundred; Dmitri Nepogodiev; Richard P T Evans; Pritam Singh; Ewen A Griffiths Journal: Dis Esophagus Date: 2020-03-16 Impact factor: 3.429
Authors: F Klevebro; J A Elliott; A Slaman; B D Vermeulen; S Kamiya; C Rosman; S S Gisbertz; P R Boshier; J V Reynolds; I Rouvelas; G B Hanna; M I van Berge Henegouwen; S R Markar Journal: Ann Surg Oncol Date: 2019-06-10 Impact factor: 5.344
Authors: J A H Gooszen; L Goense; S S Gisbertz; J P Ruurda; R van Hillegersberg; M I van Berge Henegouwen Journal: Br J Surg Date: 2018-02-07 Impact factor: 6.939