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Reoperation after oesophageal cancer surgery in relation to long-term survival: a population-based cohort study
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
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2014 (English)In: BMJ Open, ISSN 2044-6055, Vol. 4, no 3, e004648Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The influence of reoperation on long-term prognosis is unknown. In this large population-based cohort study, it was aimed to investigate the influence of a reoperation within 30 days of oesophageal cancer resection on survival even after excluding the initial postoperative period.

DESIGN: This was a nationwide population-based retrospective cohort study.

SETTING: All hospitals performing oesophageal cancer resections during the study period (1987-2010) in Sweden.

PARTICIPANTS: Patients operated for oesophageal cancer with curative intent in 1987-2010.

PRIMARY AND SECONDARY OUTCOMES: Adjusted HRs of all cause, early and late mortality up to 5 years after reoperation following oesophageal cancer resection.

RESULTS: Among 1822 included patients, the 200 (11%) who were reoperated had a 27% increased HR of all-cause mortality (adjusted HR 1.27, 95% CI 1.05 to 1.53) and 28% increased HR of disease-specific mortality (adjusted HR 1.28, 95% CI 1.04 to 1.59), compared to those not reoperated. Reoperation for anastomotic insufficiency in particular was followed by an increased mortality (adjusted HR 1.82, 95% CI 1.19 to 2.76).

CONCLUSIONS: This large and population-based nationwide cohort study shows that reoperation within 30 days after primary oesophageal resection was associated with increased mortality, even after excluding the initial 3 months after surgery. This finding stresses the need to consider any actions that might prevent complications and reoperation after oesophageal cancer resection.

Place, publisher, year, edition, pages
2014. Vol. 4, no 3, e004648
National Category
URN: urn:nbn:se:umu:diva-102760DOI: 10.1136/bmjopen-2013-004648ISI: 000333921300058PubMedID: 24650808OAI: diva2:809567
Available from: 2015-05-04 Created: 2015-05-04 Last updated: 2015-07-23Bibliographically approved

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Rutegård, Martin
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