New-Onset Anastomotic Leakage Is Not Associated With Changes In Preoperative Nutritional Status Induced By Concurrent Chemoradiotherapy In Esophageal Cancer Patients

This study explored the frequency and nutritional prognostic impact of anastomotic leakage in surgical patients with concurrent chemoradiotherapy (CCR) for esophageal cancer, and the possible association between preoperative nutritional status and occurrence of anastomotic leakage. Data were collected from 178 patients in a prospective randomised study of preoperative CCR for esophageal cancer in our center, 102 patients underwent surgery only and 76 patients received CCR followed by surgery. CCR decreased the blood cell counts, including red (P = 0.000) and white blood cells (P = 0.000), as well as the serum albumin level (P = 0.000). In contrast, serum uric acid (P = 0.029), cholesterol (P = 0.026) and triglyceride (P = 0.023) were higher in patients with preoperative CCR. After surgery, 25 patients (14.0%) had new-onset anastomotic leaks; 15 of 102 (14.7%) of the patients who received surgery only and 10 of 76 (13.2%) among the patients who received CCR followed by surgery. Multivariate analysis suggested that all of the relevant markers that were altered by CCR, including decreased blood cell counts and serum albumin level, and increased serum uric acid, cholesterol and triglyceride, did not predict occurrence of an anastomotic leak. Regarding anastomotic leakage, preoperative CCR does not complicate surgery in esophageal cancer patients. Alterations in nutritional markers induced by preoperative CCR do not appear to predict a new-onset anastomotic complication.