Effects of Postoperative Complications on Overall Survival Following Esophagectomy: A Meta-Analysis Using the Restricted Mean Survival Time Analysis.

IF 2.3 3区 医学 Q3 ONCOLOGY Thoracic Cancer Pub Date : 2025-02-01 DOI:10.1111/1759-7714.70011
Yongbo Yang, Chunyang Han, Xing Xing, Zhen Qin, Qianning Wang, Lu Lan, He Zhu
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Abstract

Objective: This study aims to conduct a comprehensive meta-analysis of the effects of postoperative complications (PCs) on survival following esophagectomy using the restricted mean survival time (RMST) analysis.

Methods: A systematic literature search was performed in PubMed, Embase, Web of Science, Cochrane, and Medline, including articles published up to July 2024. Data were reconstructed from Kaplan-Meier curves, and the difference in RMST (RMSTD) and the RMST/restricted mean time loss (RMTL) ratios were calculated to examine the effects of PCs on overall survival.

Results: A total of 12 articles, including 7925 patients, met the inclusion criteria. RMSTD estimates indicate that patients with overall PCs survived an average of 0.04 years shorter (RMSTD = -0.04, 95% CI: -0.06, -0.03) than those without PCs at the 1-year follow-up and 0.39 years shorter (RMSTD = -0.39, 95% CI: -0.55, -0.22) at the 5-year follow-up. Patients with anastomotic leaks survived an average of 0.34 years shorter (RMSTD = -0.34, 95% CI: -0.49, -0.19), and patients with pulmonary complications survived an average of 0.63 years shorter (RMSTD = -0.63, 95% CI: -0.81, -0.45) at the 5-year follow-up. Additionally, RMTL ratios were estimated to be 1.21 (95% CI: 1.12, 1.31) for overall PCs, 1.19 (95% CI: 1.11, 1.28) for anastomotic leaks, and 1.53 (95% CI: 1.36, 1.73) for pulmonary complications at the 5-year follow-up, respectively.

Conclusions: Our findings quantified the annual negative impact of PCs of esophageal cancer on overall patient survival following esophagectomy. Increased efforts are needed to enhance prevention, early screening, and timely treatment for complications, particularly for patients with pulmonary complications.

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术后并发症对食管切除术后总生存率的影响:一项使用限制平均生存时间分析的荟萃分析。
目的:本研究旨在采用限制平均生存时间(RMST)分析,对食管切除术后术后并发症(PCs)对生存的影响进行综合meta分析。方法:系统检索PubMed、Embase、Web of Science、Cochrane和Medline等网站的文献,检索截止到2024年7月发表的文章。根据Kaplan-Meier曲线重建数据,计算RMST (RMSTD)和RMST/限制平均时间损失(RMTL)比值的差异,以检验pc对总生存的影响。结果:共有12篇文章7925例患者符合纳入标准。RMSTD估计表明,在1年随访中,总体PCs患者比无PCs患者平均缩短0.04年(RMSTD = -0.04, 95% CI: -0.06, -0.03),在5年随访中缩短0.39年(RMSTD = -0.39, 95% CI: -0.55, -0.22)。在5年随访中,吻合口瘘患者的平均生存期缩短0.34年(RMSTD = -0.34, 95% CI: -0.49, -0.19),肺部并发症患者的平均生存期缩短0.63年(RMSTD = -0.63, 95% CI: -0.81, -0.45)。此外,在5年随访中,总体pc的RMTL比率估计分别为1.21 (95% CI: 1.12, 1.31),吻合口漏的RMTL比率估计为1.19 (95% CI: 1.11, 1.28),肺部并发症的RMTL比率估计为1.53 (95% CI: 1.36, 1.73)。结论:我们的研究结果量化了食管癌pc对食管切除术后患者总体生存的年度负面影响。需要加大努力,加强对并发症的预防、早期筛查和及时治疗,特别是对肺部并发症患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Thoracic Cancer
Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM
CiteScore
5.20
自引率
3.40%
发文量
439
审稿时长
2 months
期刊介绍: Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.
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