PLoS ONE (Jan 2022)

Risk stratification of cirrhotic patients undergoing esophagectomy for esophageal cancer: A single-centre experience

  • Julia K. Grass,
  • Natalie Küsters,
  • Marius Kemper,
  • Jan Tintrup,
  • Felix Piecha,
  • Jakob R. Izbicki,
  • Daniel Perez,
  • Nathaniel Melling,
  • Maximilian Bockhorn,
  • Matthias Reeh

Journal volume & issue
Vol. 17, no. 3

Abstract

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Background Concomitant liver cirrhosis is a crucial risk factor for major surgeries. However, only few data are available concerning cirrhotic patients requiring esophagectomy for malignant disease. Methods From a prospectively maintained database of esophageal cancer patients, who underwent curative esophagectomy between 01/2012 and 01/2016, patients with concomitant liver cirrhosis (liver-cirrhotic patients, LCP) were compared to non-liver-cirrhotic patients (NLCP). Results Of 170 patients, 14 cirrhotic patients with predominately low MELD scores (≤ 9, 64.3%) were identified. Perioperative outcome was significantly worse for LCP, as proofed by 30-day (57.1% vs. 7.7, pConclusion Curative esophagectomy for cirrhotic patients is associated with a dismal prognosis and should be evaluated critically. While MELD and Child score failed to predict perioperative mortality, Bilirubin and INR proofed excellent prognostic capacity in this cohort.