17 - Freie Mitteilung
15. Mai 2019, 13:30 - 15:00, Bellavista 2, 6. OG
Exploring postoperative decrease of albuminemia as predictor of complications after oncological esophagectomy: An international multicenter study
I. Labgaa1, S. Mantziari1, J. Pasquier1, M. Messier2, J.-A. Elliott3, S. Kamiya4, M.-C. Kalff5, M. Winiker1, M. Hübner1, P. Allemann1, M.-I. van Berge Henegouwen5, M. Nilsson4, J. Reynolds3, G. Piessen2, N. Demartines1, M. Schäfer1, Presenter: I. Labgaa1 (1Lausanne, 2Lille/FR, 3Dublin/IE, 4Stockholm/SE, 5Amsterdam/NL)
The predictive value of postoperative albuminemia decrease (ΔAlb) has been increasingly evidenced in major surgery but data on esophagectomy remain scarce. This study aimed to assess the predictive value of ΔAlb for adverse short-term outcomes after oncological esophagectomy.
Retrospective analysis of an international multicentric cohort of patients undergoing oncological esophagectomy between 2006-2017. Patients with missing pre- and postoperative albumin values were excluded from the analysis. Primary endpoint was postoperative complications according to Clavien classification. Secondary endpoints were Comprehensive Complication Index (CCI) and length of hospital stay (LoS).
A total of 1046 patients were analyzed. Overall and major complications were reported in 889 (85%) and 363 (34.7%) patients, respectively. Albuminemia showed a rapid postoperative decrease on POD1 (ΔAlb POD1) with a median value of 11 g/L. ROC curve analysis determined an ideal cut-off of 11 g/L for the prediction of overall complications. Patients with ΔAlb POD1 ≥11 g/L showed increased overall complications (p=0.004), major complications (p=0.009) and CCI (p=0.006) while LoS was comparable (p=0.099). On multivariable analyses, ΔAlb POD1 ≥11 g/L was an independent predictor of both overall complications (OR: 1.55; 95% CI 1.09-2.21; p=0.015) and major complications (OR: 1.43; 95% CI 1.09-1.89; p=0.009).
Oncological esophagectomy was followed by a rapid decrease of albuminemia. ΔAlb POD1 ≥11 g/L was independently associated with overall and major postoperative complications. ΔAlb appears as a promising biomarker to detect patients at higher risk of adverse outcomes after oncological esophagectomy.