The impact of perioperative outcomes on long-term survival after esophageal cancer resection

Objective: Current metrics for quality of care after esophagectomy rely on short-term perioperative outcomes. We aimed to evaluate the relationship of perioperative outcomes and long-term survival after esophagectomy for esophageal cancer. Methods: Institutions in the National Cancer Database performing ≥20 esophagectomies (2010-2019) were ranked by a weighted composite score of major perioperative events-length of stay >20 days, unplanned readmissions, and 30-day mortality-and stratified into quintiles. Survival between centers with the least perioperative morbidity (quintile 1) and all other centers (quintiles 2-5) was compared using Kaplan-Meier, Cox proportional hazard, and landmark analyses. Results: = .036). Conclusions: Our study demonstrates that patients undergoing esophagectomy for esophageal cancer at centers with lower rates of major perioperative events had improved long-term survival, suggesting that short-term metrics can serve as indicators of long-term performance and oncologic efficacy.