Journal Article

F-026VALIDATION OF A NEW APPROACH FOR MORTALITY RISK ASSESMENT IN OESOPHAGECTOMY FOR CANCER BASED ON AGE- AND GENDER-CORRECTED BODY MASS INDEX

Hans Van Veer, J. Moons, G. Darling, T. Lerut, W. Coosemans, T. Waddell, P. De Leyn and P. Nafteux

in Interactive CardioVascular and Thoracic Surgery

Published on behalf of European Association for Cardio-Thoracic Surgery

Volume 18, issue suppl_1, pages S7-S7
Published in print June 2014 | ISSN: 1569-9293
Published online June 2014 | e-ISSN: 1569-9285 | DOI: https://dx.doi.org/10.1093/icvts/ivu167.26
F-026VALIDATION OF A NEW APPROACH FOR MORTALITY RISK ASSESMENT IN OESOPHAGECTOMY FOR CANCER BASED ON AGE- AND GENDER-CORRECTED BODY MASS INDEX

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  • Cardiovascular Medicine
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Objectives: We developed a new algorithm to identify high-risk patients for underweight after oesophagectomy for cancer. Patients are assigned to an age-gender-specific body mass index-percentile (AG-BMI) which is then used in a survival analysis. This model is able to identify more patients at risk for underweight in comparison to the classically used BMI. It shows a worse overall survival (OS) in patients with a preoperative AG-BMI <10th-percentile. The aim of this study is to validate this new model based on a cohort of patients from an external high-volume institution specialized in oesophageal cancer surgery.

Methods: The validation cohort consists of 407 patients operated on between 1999 and 2012 with the prerequisite data to calculate AG-BMI and OS. The base cohort consisted of 642 consecutive patients, operated on in our institution between 2005 and 2010. Age, gender, height and weight on the day before surgery were used to calculate BMI and AG-BMI. OS was analysed and a multivariate analysis was performed.

Results: Incidence rates of the AG-BMI <10th-percentile risk-patients in the validation cohort showed similar results to our original results (17.2% for both institutions) with a similar significant OS difference between at-risk-patients and not-at-risk-patients (P < 0.001). Multivariate analysis found the same five independent prognosticators for OS in both datasets: age, early versus advanced disease, resection status, number of positive lymph nodes and the AG-BMI-10th percentile, but not BMI itself. In the validation cohort, gender was identified as an additional independent prognosticator. The worse OS survival in AG-BMI <10th-percentile in both patient populations was related to a significantly higher number of deaths without oesophageal cancer recurrence.

Conclusions: This study validates the newly developed AG-BMI model to predict more accurately a subgroup of patients at risk for worse survival after oesophagectomy. Improved perioperative identification of risk factors for poorer OS could help to develop perioperative strategies to reduce these risks.

Disclosure: No significant relationships.

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine ; Cardiothoracic Surgery

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