AbstractBackground and purpose Prevention of treatment-related complications remains a major challenge in esophageal cancer (EC) patients undergoing neoadjuvant chemoradiotherapy (nCRT) ± surgery. A single measure, reflecting the total complication burden, may provide a clear overall picture of patient burden and enables a direct comparison of alternative treatment strategies. We developed a Complication Sum Score (CSS) to quantify symptomatic complications. Materials and methods A Delphi consensus procedure was used to develop the CCS using the expertise of health professionals to assess the impact of a spectrum of complications. The impact of each complication was scored on a 0–100 scale. Consensus for these scores was defined as an interquartile range ≤ 20. The association between the CSS and hospital/ICU stay, overall survival (OS) at 1 year and quality of life (QoL) was assessed in a multicenter dataset of patients with EC, using multivariable (logistic) regression analysis, correcting for possible confounders. Results Forty-five experts completed the two-round Delphi procedure. Consensus was reached for all (36) complications. In 1225 patients, that underwent nCRT and esophagectomy, a higher CSS was significantly associated with a longer hospital (coefficient = 0.430.38–0.48, p Conclusion The CSS offers a comprehensive tool to quantify treatment-related complications in a single score in EC patients that receive nCRT followed by surgical resection.
Frederiks et al. (Sun,) studied this question.