Open AccessThe PER (Preoperative Esophagectomy Risk) Score
Author(s) -
Matthias Reeh,
Johannes Metze,
Faik G. Uzunoğlu,
Michael Nentwich,
Tarik Ghadban,
Ulrich Wellner,
Maximilian Bockhorn,
Stefan Kluge,
Jakob R. Izbicki,
Yogesh K. Vashist,
Johannes Metze,
Johannes Metze,
Johannes Metze,
Johannes Metze,
Johannes Metze,
Johannes Metze,
Johannes Metze,
Johannes Metze,
Faik G. Uzunoğlu,
Faik G. Uzunoğlu,
Faik G. Uzunoğlu,
Faik G. Uzunoğlu,
Faik G. Uzunoğlu,
Faik G. Uzunoğlu,
Faik G. Uzunoğlu,
Faik G. Uzunoğlu,
Faik G. Uzunoğlu,
Michael Nentwich,
Michael Nentwich,
Michael Nentwich,
Michael Nentwich,
Michael Nentwich,
Michael Nentwich,
Michael Nentwich,
Michael Nentwich,
Michael Nentwich,
Tarik Ghadban,
Tarik Ghadban,
Tarik Ghadban,
Tarik Ghadban,
Tarik Ghadban,
Tarik Ghadban,
Tarik Ghadban,
Tarik Ghadban,
Tarik Ghadban,
Ulrich Wellner,
Ulrich Wellner,
Ulrich Wellner,
Ulrich Wellner,
Ulrich Wellner,
Ulrich Wellner,
Ulrich Wellner,
Ulrich Wellner,
Ulrich Wellner,
Maximilian Bockhorn,
Maximilian Bockhorn,
Maximilian Bockhorn,
Maximilian Bockhorn,
Maximilian Bockhorn,
Maximilian Bockhorn,
Maximilian Bockhorn,
Maximilian Bockhorn,
Maximilian Bockhorn,
Stefan Kluge,
Stefan Kluge,
Stefan Kluge,
Stefan Kluge,
Stefan Kluge,
Stefan Kluge,
Stefan Kluge,
Stefan Kluge,
Stefan Kluge,
Jakob R. Izbicki,
Jakob R. Izbicki,
Jakob R. Izbicki,
Jakob R. Izbicki,
Jakob R. Izbicki,
Jakob R. Izbicki,
Jakob R. Izbicki,
Jakob R. Izbicki,
Jakob R. Izbicki,
Yogesh K. Vashist,
Yogesh K. Vashist,
Yogesh K. Vashist,
Yogesh K. Vashist,
Yogesh K. Vashist,
Yogesh K. Vashist,
Yogesh K. Vashist,
Yogesh K. Vashist,
Yogesh K. Vashist
Publication year - 2016
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000002724
Subject(s) - medicine , esophagectomy , esophageal cancer , hazard ratio , retrospective cohort study , cohort , surgery , framingham risk score , proportional hazards model , cohort study , stage (stratigraphy) , cancer , confidence interval , disease , paleontology , biology
Esophageal resection in patients with esophageal cancer (EC) is still associated with high mortality and morbidity rates. We aimed to develop a simple preoperative risk score for the prediction of short-term and long-term outcomes for patients with EC treated by esophageal resection. In total, 498 patients suffering from esophageal carcinoma, who underwent esophageal resection, were included in this retrospective cohort study. Three preoperative esophagectomy risk (PER) groups were defined based on preoperative functional evaluation of different organ systems by validated tools (revised cardiac risk index, model for end-stage liver disease score, and pulmonary function test). Clinicopathological parameters, morbidity, and mortality as well as disease-free survival (DFS) and overall survival (OS) were correlated to the PER score. The PER score significantly predicted the short-term outcome of patients with EC who underwent esophageal resection. PER 2 and PER 3 patients had at least double the risk of morbidity and mortality compared to PER 1 patients. Furthermore, a higher PER score was associated with shorter DFS ( P < 0.001) and OS ( P < 0.001). The PER score was identified as an independent predictor of tumor recurrence (hazard ratio [HR] 2.1; P < 0.001) and OS (HR 2.2; P < 0.001). The PER score allows preoperative objective allocation of patients with EC into different risk categories for morbidity, mortality, and long-term outcomes. Thus, multicenter studies are needed for independent validation of the PER score.