TY - JOUR
T1 - Analysis of risk factors for post-operative complications and prognostic predictors of disease recurrence following definitive treatment of patients with esophageal cancer from two medical centers in Northwest China
AU - Wang, Jichang
AU - Zhang, Boxiang
AU - Meng, Jinying
AU - Xiao, Guodong
AU - Li, Xiang
AU - Li, Gang
AU - Qin, Sida
AU - Du, Ning
AU - Zhang, Jia
AU - Zhang, Jing
AU - Xu, Chongwen
AU - Tang, Shou-Ching
AU - Liang, Rui
AU - Ren, Hong
AU - Sun, Xin
N1 - Funding Information:
The authors of the present study would like to acknowledge the help of assistants from the Center for Translational Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, and the Institute of Urinary Surgery, the Key Laboratory, Ministry of Education, The First Affiliated Hospital of Xi’an Jiaotong University. The current study was supported by the National Natural Science Foundation for Young Scientists of China (grant no. 81602597; awarded to Dr Xin Sun; grant no. 81402506, awarded to Professor Sida Qin), the National Natural Science Foundation of China (grant no. 81272418; awarded to Professor Hong Ren).
Publisher Copyright:
© 2017, Spandidos Publications. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Evaluating the clinicopathological features of patients receiving definitive treatment for esophageal cancer may facilitate the identification of patterns and factors associated with post-operative complications, and enable the development of a surveillance strategy for surviving patients at a higher risk of disease recurrence. In the present study, clinical data from 579 patients with esophageal cancer that underwent radical resection of esophagus were collected. These patients were admitted to two medical centers in Northwest China, and information regarding the presence or absence of basic chronic diseases and post-operative results were retrospectively analyzed. The level of selected stem cell markers, including aldehyde dehydrogenase 1, CD133, integrin subunitα 6, integrin subunit β 4 and T-cell factor-4, were determined in esophageal cancer tissue samples in order to determine whether these markers may be useful predictors of disease prognosis and recurrence. Post-operative complications in patients receiving radical resection of the esophagus included respiratory system complications, cardiovascular abnormalities and esophageal anastomotic fistulae. Diabetes, basic respiratory disease and lower pre-surgical serum albumin levels were observed to be individual risk factors associated with post-operative complications, including respiratory system complications of acute respiratory failure and pulmonary infection, cardiovascular abnormalities of atrial fibrillation and arrhythmia, as well as the development of esophageal anastomotic fistulae. Diagnosis of esophageal cancer at later stage was significantly correlated with anastomotic fistula. Molecular detection of stem cell markers for prognosis prediction was achieved by immunohistochemical and immunofluorescence staining assays. The results demonstrated that the presence of stem-like cells in cancer tissues was associated with poor disease prognosis and a high recurrence ratio. In conclusion, the results of the current study suggested that post-operative complications were more likely to occur in patients with diabetes, basic respiratory disease or lower serum albumin levels prior to surgery. Therefore, sufficient intensive peri-operative care, rigorous operative risk assessments, and the selection of the patients with early or mid-stage esophageal cancer, may decrease the risk of post-surgical complications in patients receiving radical resection of the esophagus. In addition, a high ratio of esophageal cancer stem-like cells was associated with cancer recurrence. These results suggest that an intensive surveillance strategy should be implemented in order to facilitate early detection of disease recurrence and improve the clinical management of these patients post-surgery.
AB - Evaluating the clinicopathological features of patients receiving definitive treatment for esophageal cancer may facilitate the identification of patterns and factors associated with post-operative complications, and enable the development of a surveillance strategy for surviving patients at a higher risk of disease recurrence. In the present study, clinical data from 579 patients with esophageal cancer that underwent radical resection of esophagus were collected. These patients were admitted to two medical centers in Northwest China, and information regarding the presence or absence of basic chronic diseases and post-operative results were retrospectively analyzed. The level of selected stem cell markers, including aldehyde dehydrogenase 1, CD133, integrin subunitα 6, integrin subunit β 4 and T-cell factor-4, were determined in esophageal cancer tissue samples in order to determine whether these markers may be useful predictors of disease prognosis and recurrence. Post-operative complications in patients receiving radical resection of the esophagus included respiratory system complications, cardiovascular abnormalities and esophageal anastomotic fistulae. Diabetes, basic respiratory disease and lower pre-surgical serum albumin levels were observed to be individual risk factors associated with post-operative complications, including respiratory system complications of acute respiratory failure and pulmonary infection, cardiovascular abnormalities of atrial fibrillation and arrhythmia, as well as the development of esophageal anastomotic fistulae. Diagnosis of esophageal cancer at later stage was significantly correlated with anastomotic fistula. Molecular detection of stem cell markers for prognosis prediction was achieved by immunohistochemical and immunofluorescence staining assays. The results demonstrated that the presence of stem-like cells in cancer tissues was associated with poor disease prognosis and a high recurrence ratio. In conclusion, the results of the current study suggested that post-operative complications were more likely to occur in patients with diabetes, basic respiratory disease or lower serum albumin levels prior to surgery. Therefore, sufficient intensive peri-operative care, rigorous operative risk assessments, and the selection of the patients with early or mid-stage esophageal cancer, may decrease the risk of post-surgical complications in patients receiving radical resection of the esophagus. In addition, a high ratio of esophageal cancer stem-like cells was associated with cancer recurrence. These results suggest that an intensive surveillance strategy should be implemented in order to facilitate early detection of disease recurrence and improve the clinical management of these patients post-surgery.
KW - Anastomotic fistula
KW - Cancer stem-like cells
KW - Esophageal cancer
KW - Post-operative complications
KW - Prognosis prediction
UR - http://www.scopus.com/inward/record.url?scp=85026765777&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85026765777&partnerID=8YFLogxK
U2 - 10.3892/etm.2017.4835
DO - 10.3892/etm.2017.4835
M3 - Article
AN - SCOPUS:85026765777
SN - 1792-0981
VL - 14
SP - 2584
EP - 2594
JO - Experimental and Therapeutic Medicine
JF - Experimental and Therapeutic Medicine
IS - 3
ER -