PERIOPERATIVE RISK-FACTORS IN PATIENTS WITH ESOPHAGEAL-CARCINOMA - A RETROSPECTIVE STUDY TO IDENTIFY INDEPENDENT VARIABLES

The postoperative outcome of 127 patients with an esophageal carcinoma was investigated retrospectively, to identify independent factors for the perioperative mortality (hospital mortality). Chi-square single f actor analysis was employed to test 35 independent variables, in a sec ond analysis stepwise logistic regression was used to determine the fa ctors correlating with the mortality. In 41 patients the esophagus was resected by a thoraco-abdominal approach, in 86 by blunt dissection. The hospital mortality was 17.3 %, the 30-day mortality 12.6 %. Single factor analysis revealed a significant correlation with the variable smoking (p < 0.003), post-operative morbidity (p < 0.008), CEA (p < 0. 02), time of operation (p < 0.02) and surgical procedures (p < 0.02). The influence of die surgeon's experience was significant. In the step wise logistic regression the duration of operation (p < 0.0039), the s urgical procedures (p < 0.0 1 6), and the units of blood (p < 0.03) we re correlated with mortality. The logistic regression showed a signifi cant increase of mortality for the thoracoabdominal approach with incr easing duration of the operation. The estimation of survival time acco rding to Kaplan and Meier revealed a significant correlation with the stage of the tumor, but not with the surgical procedure.