Validation of mortality risk scores after esophagectomy
Abstract Purpose Oncological esophagectomy is the mainstay in esophageal cancer treatment, but perioperative mortality remains a significant concern. Various scoring systems exist to identify patients at high risk for postoperative complications and death. In the following, we aim to evaluate and co...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Springer
2025-01-01
|
| Series: | Journal of Cancer Research and Clinical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s00432-024-06074-w |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832572004680597504 |
|---|---|
| author | Sabine Schiefer Nerma Crnovrsanin Ingmar F. Rompen Nicolas Jorek Mohammed Al-Saeedi Thomas Schmidt Henrik Nienhüser Leila Sisic |
| author_facet | Sabine Schiefer Nerma Crnovrsanin Ingmar F. Rompen Nicolas Jorek Mohammed Al-Saeedi Thomas Schmidt Henrik Nienhüser Leila Sisic |
| author_sort | Sabine Schiefer |
| collection | DOAJ |
| description | Abstract Purpose Oncological esophagectomy is the mainstay in esophageal cancer treatment, but perioperative mortality remains a significant concern. Various scoring systems exist to identify patients at high risk for postoperative complications and death. In the following, we aim to evaluate and compare these different scoring systems. Methods We analyzed data from 714 patients who underwent esophagectomy between 2002 and 2021. Each patient’s risk was calculated using three models: the International Esodata Study Group (IESG) 90-day mortality risk prediction, the Steyerberg 30-day mortality score, and the Fuchs et al. preoperative in-hospital mortality score (Fuchs score). The diagnostic performance of these models was assessed using the area under the receiver operating characteristic (ROC) curves. Results Of the 714 patients, the majority (87.67%) underwent abdomino-thoracic esophagectomy with intrathoracic anastomosis. The IESG score classified 52.1% as very low, 26.6% low, 17.5% middle, 2.8% high, and 1% as very high risk, while the Fuchs score identified 94.5% as low-risk and 5.5% as high-risk patients. Mortality rates were 6.9% at 90 days, 3.4% at 30 days, and 6.7% in-hospital. The area under the ROC curve was 0.634 (95%CI: 0.557–0.712) for the IESG model, 0.637 (95%CI: 0.526–0.747) for the Steyerberg score, and 0.686 (95%CI: 0.611–0.760) for the Fuchs score. Conclusions Existing risk score systems provide a possibility for preoperative risk stratification, particularly for identifying high-risk patients. However, due to their limited predictive ability, improvements are needed to apply these strategies effectively in clinical practice. |
| format | Article |
| id | doaj-art-65f03d24c08f4e54971bbb847c01ccfc |
| institution | Kabale University |
| issn | 1432-1335 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Springer |
| record_format | Article |
| series | Journal of Cancer Research and Clinical Oncology |
| spelling | doaj-art-65f03d24c08f4e54971bbb847c01ccfc2025-02-02T12:07:14ZengSpringerJournal of Cancer Research and Clinical Oncology1432-13352025-01-0115121810.1007/s00432-024-06074-wValidation of mortality risk scores after esophagectomySabine Schiefer0Nerma Crnovrsanin1Ingmar F. Rompen2Nicolas Jorek3Mohammed Al-Saeedi4Thomas Schmidt5Henrik Nienhüser6Leila Sisic7Department of General, Visceral and Transplantation Surgery, University Hospital HeidelbergDepartment of General, Visceral and Transplantation Surgery, University Hospital HeidelbergDepartment of General, Visceral and Transplantation Surgery, University Hospital HeidelbergDepartment of General, Visceral and Transplantation Surgery, University Hospital HeidelbergDepartment of General, Visceral and Transplantation Surgery, University Hospital HeidelbergDepartment of General, Visceral and Cancer Surgery, University Hospital of CologneDepartment of General, Visceral and Transplantation Surgery, University Hospital HeidelbergDepartment of General, Visceral and Transplantation Surgery, University Hospital HeidelbergAbstract Purpose Oncological esophagectomy is the mainstay in esophageal cancer treatment, but perioperative mortality remains a significant concern. Various scoring systems exist to identify patients at high risk for postoperative complications and death. In the following, we aim to evaluate and compare these different scoring systems. Methods We analyzed data from 714 patients who underwent esophagectomy between 2002 and 2021. Each patient’s risk was calculated using three models: the International Esodata Study Group (IESG) 90-day mortality risk prediction, the Steyerberg 30-day mortality score, and the Fuchs et al. preoperative in-hospital mortality score (Fuchs score). The diagnostic performance of these models was assessed using the area under the receiver operating characteristic (ROC) curves. Results Of the 714 patients, the majority (87.67%) underwent abdomino-thoracic esophagectomy with intrathoracic anastomosis. The IESG score classified 52.1% as very low, 26.6% low, 17.5% middle, 2.8% high, and 1% as very high risk, while the Fuchs score identified 94.5% as low-risk and 5.5% as high-risk patients. Mortality rates were 6.9% at 90 days, 3.4% at 30 days, and 6.7% in-hospital. The area under the ROC curve was 0.634 (95%CI: 0.557–0.712) for the IESG model, 0.637 (95%CI: 0.526–0.747) for the Steyerberg score, and 0.686 (95%CI: 0.611–0.760) for the Fuchs score. Conclusions Existing risk score systems provide a possibility for preoperative risk stratification, particularly for identifying high-risk patients. However, due to their limited predictive ability, improvements are needed to apply these strategies effectively in clinical practice.https://doi.org/10.1007/s00432-024-06074-wEsophagus cancerRisk assessmentMortality risk score |
| spellingShingle | Sabine Schiefer Nerma Crnovrsanin Ingmar F. Rompen Nicolas Jorek Mohammed Al-Saeedi Thomas Schmidt Henrik Nienhüser Leila Sisic Validation of mortality risk scores after esophagectomy Journal of Cancer Research and Clinical Oncology Esophagus cancer Risk assessment Mortality risk score |
| title | Validation of mortality risk scores after esophagectomy |
| title_full | Validation of mortality risk scores after esophagectomy |
| title_fullStr | Validation of mortality risk scores after esophagectomy |
| title_full_unstemmed | Validation of mortality risk scores after esophagectomy |
| title_short | Validation of mortality risk scores after esophagectomy |
| title_sort | validation of mortality risk scores after esophagectomy |
| topic | Esophagus cancer Risk assessment Mortality risk score |
| url | https://doi.org/10.1007/s00432-024-06074-w |
| work_keys_str_mv | AT sabineschiefer validationofmortalityriskscoresafteresophagectomy AT nermacrnovrsanin validationofmortalityriskscoresafteresophagectomy AT ingmarfrompen validationofmortalityriskscoresafteresophagectomy AT nicolasjorek validationofmortalityriskscoresafteresophagectomy AT mohammedalsaeedi validationofmortalityriskscoresafteresophagectomy AT thomasschmidt validationofmortalityriskscoresafteresophagectomy AT henriknienhuser validationofmortalityriskscoresafteresophagectomy AT leilasisic validationofmortalityriskscoresafteresophagectomy |