Key result
Physical fitness factors including grip strength predict major post-esophagectomy complications with ~76% accuracy.
Why the study?
Postoperative complications after esophagectomy following neoadjuvant or definitive chemoradiotherapy are frequent and adversely affect survival, but physical fitness predictors across multiple domains remained to be identified.
Does preoperative physical fitness predict major postoperative complications in patients undergoing esophagectomy for esophageal squamous cell carcinoma after chemoradiotherapy?
Cohort
Does preoperative physical fitness predict major postoperative complications in patients undergoing esophagectomy for esophageal squamous cell carcinoma after chemoradiotherapy?
Preoperative physical fitness screening, particularly assessing nadir and hand grip strength, can help identify patients at high risk for major complications following esophagectomy.
May aid preoperative risk stratification before esophagectomy; leaves open whether fitness optimization reduces complications.
BACKGROUND: Esophagectomy following neoadjuvant chemoradiotherapy or definitive chemoradiotherapy has been shown to yield favorable oncological outcomes in patients with locally advanced esophageal squamous cell carcinoma. However, postoperative complications are frequent and can adversely affect patient survival. This study aimed to identify physical fitness factors across multiple domains associated with major postoperative complications. METHODS: This study enrolled patients with esophageal squamous cell carcinoma who were treated with neoadjuvant chemoradiotherapy or definitive chemoradiotherapy and underwent esophagectomy between 2020 and 2022. Multivariate logistic regression analysis was conducted to identify the factors associated with major postoperative complications. Additionally, a tree-based learning process was employed to assess all the variables influencing major complications. RESULTS: nadir, and hand grip strength emerged as the key predictors of major post-esophagectomy complications in the tree-based learning analysis, which showed a sensitivity of 0.448, specificity of 0.977, and accuracy of 76.4%, with false negative and false positive rates of 55.2% and 2.3%. AV̇P alone yielded similar results. CONCLUSIONS: nadir, and low HGS are at a very high risk of experiencing major postoperative complications, with low AV̇P showing the strongest correlation. Preoperative physical fitness screening can help identify high-risk patients and guide appropriate perioperative management.
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Chiu et al. (2025) conducted a cohort in Esophageal squamous cell carcinoma. Physical fitness factors (nadir, hand grip strength, AV̇P) was evaluated on Major postoperative complications. Physical fitness factors, including nadir and hand grip strength, predicted major post-esophagectomy complications with 76.4% accuracy, 0.448 sensitivity, and 0.977 specificity.
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