Comparison of short-term outcomes from the International Oesophago-Gastric Anastomosis Audit (OGAA), the Esophagectomy Complications Consensus Group (ECCG), and the Dutch Upper Gastrointestinal Cancer Audit (DUCA)
Authors:   Oesophago-Gastric Anastomosis Study Group, Fergusson J , Beenen E , Mosse C , Salim J , Cheah S , Wright T , Cerdeira MP , McQuillan P , Richardson M , Liem H , Spillane J , Yacob M , Albadawi F , Thorpe T , Dingle A , Cabalag C , Loi K , Fisher OM , Ward S , Read M , Johnson M , Bassari R , Bui H , Cecconello I , Sallum RAA , da Rocha JRM , Lopes LR , Tercioti V , Coelho JDS , Ferrer JAP , Buduhan G , Tan L , Srinathan S , Shea P , Yeung J , Allison F , Carroll P , Vargas-Barato F , Gonzalez F , Ortega J , Nino-Torres L , Beltrán-García TC , Castilla L , Pineda M , Bastidas A , Gómez-Mayorga J , Cortés N , Cetares C , Caceres S , Duarte S , Pazdro A , Snajdauf M , Faltova H , Sevcikova M , Mortensen PB , Katballe N , Ingemann T , Morten B , Kruhlikava I , Ainswort AP , Stilling NM , Eckardt J , Holm J , Thorsteinsson M , Siemsen M , Brandt B , Nega B , Teferra E , Tizazu A , Kauppila JS , Koivukangas V , Meriläinen S , Gruetzmann R , Krautz C , Weber G , Golcher H , Emons G , Azizian A , Ebeling M , Niebisch S , Kreuser N , Albanese G , Hesse J , Volovnik L , Boecher U , Reeh M , Triantafyllou S , Schizas D , Michalinos A , Mpali E , Mpoura M , Charalabopoulos A , Manatakis DK , Balalis D , Bolger J , Baban C , Mastrosimone A , McAnena O , Quinn A , Ó Súilleabháin CB , Hennessy MM , Ivanovski I , Khizer H , Ravi N , Donlon N , Cervellera M , Vaccari S , Bianchini S , Sartarelli l , Asti E , Bernardi D , Merigliano S , Provenzano L , Scarpa M , Saadeh L , Salmaso B , De Manzoni G , Giacopuzzi S , La Mendola R , De Pasqual CA , Tsubosa Y , Niihara M , Irino T , Makuuchi R , Ishii K , Mwachiro M , Fekadu A , Odera A , Mwachiro E , AlShehab D , Ahmed HA , Shebani AO , Elhadi A , Elnagar FA , Elnagar HF , Makkai-Popa ST , Wong LF , Yunrong T , Thanninalai S , Aik HC , Soon PW , Huei TJ , Basave HNL , Cortés-González R , Lagarde SM , van Lanschot JJB , Cords C , Jansen WA , Martijnse I , Matthijsen R , Bouwense S , Klarenbeek B , Verstegen M , van Workum F , Ruurda JP , van der Sluis PC , de Maat M , Evenett N , Johnston P , Patel R , MacCormick A , Young M , Smith B , Ekwunife C , Memon AH , Shaikh K , Wajid A , Khalil N , Haris M , Mirza ZU , Qudus SBA , Sarwar MZ , Shehzadi A , Raza A , Jhanzaib MH , Farmanali J , Zakir Z , Shakeel O , Nasir I , Khattak S , Baig M , Noor MA , Ahmed HH , Naeem A , Pinho AC , da Silva R , Matos H , Braga T , Monteiro C , Ramos P , Cabral F , Gomes MP , Martins PC , Correia AM , Videira JF , Ciuce C , Drasovean R , Apostu R , Ciuce C , Paitici S , Racu AE , Obleaga CV , Beuran M , Stoica B , Ciubotaru C , Negoita V , Cordos I , Birla RD , Predescu D , Hoara PA , Tomsa R , Shneider V , Agasiev M , Ganjara I , Gunjic´ D , Veselinovic´ M , Babič T , Chin TS , Shabbir A , Kim G , Crnjac A , Samo H , Díez del Val I , Leturio S , Díez del Val I , Leturio S , Ramón JM , Dal Cero M , Rifá S , Rico M , Pagan Pomar A , Martinez Corcoles JA , Rodicio Miravalles JL , Pais SA , Turienzo SA , Alvarez LS , Campos PV , Rendo AG , García SS , Santos EPG , Martínez ET , Fernández Díaz MJ , Magadán Álvarez C , Concepción Martín V , Díaz López C , Rosat Rodrigo A , Pérez Sánchez LE , Bailón Cuadrado M , Tinoco Carrasco C , Choolani Bhojwani E , Sánchez DP , Ahmed ME , Dzhendov T , Lindberg F , Rutegård M , Sundbom M , Mickael C , Colucci N , Schnider A , Er S , Kurnaz E , Turkyilmaz S , Turkyilmaz A , Yildirim R , Baki BE , Akkapulu N , Karahan O , Damburaci N , Hardwick R , Safranek P , Sujendran V , Bennett J , Afzal Z , Shrotri M , Chan B , Exarchou K , Gilbert T , Amalesh T , Mukherjee D , Mukherjee S , Wiggins TH , Kennedy R , McCain S , Harris A , Dobson G , Davies N , Wilson I , Mayo D , Bennett D , Young R , Manby P , Blencowe N , Schiller M , Byrne B , Mitton D , Wong V , Elshaer A , Cowen M , Menon V , Tan LC , McLaughlin E , Koshy R , Sharp C , Brewer H , Das N , Cox M , Al Khyatt W , Worku D , Iqbal R , Walls L , McGregor R , Fullarton G , Macdonald A , MacKay C , Craig C , Dwerryhouse S , Hornby S , Jaunoo S , Wadley M , Baker C , Saad M , Kelly M , Davies A , Di Maggio F , McKay S , Mistry P , Singhal R , Tucker O , Kapoulas S , Powell-Brett S , Davis P , Bromley G , Watson L , Verma R , Ward J , Shetty V , Ball C , Pursnani K , Sarela A , Sue Ling H , Mehta S , Hayden J , To N , Palser T , Hunter D , Supramaniam K , Butt Z , Ahmed A , Kumar S , Chaudry A , Moussa O , Kordzadeh A , Lorenzi B , Willem J , Bouras G , Evans R , Singh M , Warrilow H , Ahmad A , Tewari N , Yanni F , Couch J , Theophilidou E , Reilly JJ , Singh P , van Boxel Gijs , Akbari K , Zanotti D , Sgromo B , Sanders G , Wheatley T , Ariyarathenam A , Reece-Smith A , Humphreys L , Choh C , Carter N , Knight B , Pucher P , Athanasiou A , Mohamed I , Tan B , Abdulrahman M , Vickers J , Akhtar K , Chaparala R , Brown R , Alasmar MMA , Ackroyd R , Patel K , Tamhankar A , Wyman A , Walker R , Grace B , Abbassi N , Slim N , Ioannidi L , Blackshaw G , Havard T , Escofet X , Powell A , Owera A , Rashid F , Jambulingam P , Padickakudi J , Ben-Younes H , Mccormack K , Makey IA , Karush MK , Seder CW , Liptay MJ , Chmielewski G , Rosato EL , Berger AC , Zheng R , Okolo E , Singh A , Scott CD , Weyant MJ , Mitchell JD 
Published: February 2021

Background

The Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA) have set standards in reporting outcomes after oesophagectomy. Reporting outcomes from selected high-volume centres or centralized national cancer programmes may not, however, be reflective of the true global prevalence of complications. This study aimed to compare complication rates after oesophagectomy from these existing sources with those of an unselected international cohort from the Oesophago-Gastric Anastomosis Audit (OGAA).

Methods

The OGAA was a prospective multicentre cohort study coordinated by the West Midlands Research Collaborative, and included patients undergoing oesophagectomy for oesophageal cancer between April and December 2018, with 90 days of follow-up.

Results

The OGAA study included 2247 oesophagectomies across 137 hospitals in 41 countries. Comparisons with the ECCG and DUCA found differences in baseline demographics between the three cohorts, including age, ASA grade, and rates of chronic pulmonary disease. The OGAA had the lowest rates of neoadjuvant treatment (OGAA 75.1 per cent, ECCG 78.9 per cent, DUCA 93.5 per cent; P &lt; 0.001). DUCA exhibited the highest rates of minimally invasive surgery (OGAA 57.2 per cent, ECCG 47.9 per cent, DUCA 85.8 per cent; P &lt; 0.001). Overall complication rates were similar in the three cohorts (OGAA 63.6 per cent, ECCG 59.0 per cent, DUCA 62.2 per cent), with no statistically significant difference in Clavien–Dindo grades (P = 0.752). However, a significant difference in 30-day mortality was observed, with DUCA reporting the lowest rate (OGAA 3.2 per cent, ECCG 2.4 per cent, DUCA 1.7 per cent; P = 0.013).

Conclusion

Despite differences in rates of co-morbidities, oncological treatment strategies, and access to minimal-access surgery, overall complication rates were similar in the three cohorts.