Objective
To introduce a simple preoperative risk score for esophageal cancer (PRSEC) and its relationship with the prognosis of patients who underwent resection of esophageal carcinoma.
Methods
We retrospectively analyzed the clinical data of 498 patients receiving resection of esophageal carcinoma between 2005 and 2015 in our hospital. They were divided into three groups (PRSEC1, PRSEC2 and PRSEC3 groups) according to the results of PRSEC (revised cardiac risk index, model for end-stage liver disease score and pulmonary function test). Their overall survival (OS) and disease-free survival (DFS) were measured to find the relationship between the PRSEC and prognosis of patients.
Results
The mortality, morbidity, DFS and OS were correlative with the PRSEC. Therefore the PRSEC can be used to predict the short-term outcome. The patients with score 2 or 3 had higher risk of mortality and morbidity than those with score 1. In addition, the DFS and OS of patients with higher score were shorter (P<0.001).
Conclusion
The PRSEC is easy and efficient and can predict the morbidity, mortality, and long-term outcomes for the patients with resection of esophageal carcinoma.
Advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction (AEG) has a unique anatomical location and exhibits heterogeneous biological behavior resembling both esophageal and gastric cancers. It is associated with a high risk of bidirectional lymphatic metastasis to the abdominal cavity and mediastinum, and is often diagnosed at a relatively advanced stage. Therefore, the establishment of precision surgical treatment strategies for this disease remains challenged by several key issues. Based on the latest clinical evidence, guidelines, and expert consensus from China and abroad, and combined with our institutional clinical experience, this article discusses the individualized selection of surgical approaches, precise definition of the extent of lymphadenectomy, safe threshold for the proximal esophageal resection margin, and strategies for digestive tract reconstruction.
