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Research Papers:

Postoperative atrial fibrillation does not impact on overall survival after esophagectomy in patients with thoracic esophageal cancer: results from a randomized, double-blind, placebo-controlled trial

Toshiyasu Ojima _, Masaki Nakamura, Keiji Hayata, Junya Kitadani, Masahiro Katsuda, Mikihito Nakamori, Akihiro Takeuchi, Shimpei Maruoka, Naoki Fukuda, Shinta Tominaga, Hideki Motobayashi and Hiroki Yamaue

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Oncotarget. 2020; 11:2414-2423. https://doi.org/10.18632/oncotarget.27643

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Abstract

Toshiyasu Ojima1, Masaki Nakamura1, Keiji Hayata1, Junya Kitadani1, Masahiro Katsuda1, Mikihito Nakamori1, Akihiro Takeuchi1, Shimpei Maruoka1, Naoki Fukuda1, Shinta Tominaga1, Hideki Motobayashi1 and Hiroki Yamaue1

1 Second Department of Surgery, Wakayama Medical University, Wakayama, Japan

Correspondence to:

Toshiyasu Ojima,email: tojima@wakayama-med.ac.jp

Keywords: esophageal cancer; atrial fibrillation; landiolol; randomized controlled trial; complication

Received: April 25, 2020     Accepted: June 01, 2020     Published: June 23, 2020

ABSTRACT

Background: Administration of landiolol hydrochloride was found to be associated with reduced incidence of atrial fibrillation (AF) after esophagectomy for esophageal cancer in our previous randomized controlled trial (RCT). In addition, reduced incidence of AF was associated with reduction of other complications. Meanwhile, the effects of postoperative AF and other complications on long-term survival following esophagectomy are not well understood.

Materials and Methods: Between March 2014 and January 2016, 100 patients with esophageal cancer were registered in an RCT trial and randomly allocated to receive either administration of landiolol or a placebo. We analyzed data from this RCT to better understand the effect of postoperative AF and severe associated complications on overall survival (OS) after esophagectomy for cancer. We also examined whether prophylactic administration of landiolol hydrochloride directly affects prolonged survival in patients with esophageal cancer.

Results: The five-year rates of OS in the patients with and without AF were 60%, and 68.6%, respectively, there was no significant difference (P = 0.328). Five-year rates of OS of the patients with and without severe complications were 64.6%, and 67.5%, respectively (P = 0.995). The five-year rates of OS in the placebo and landiolol groups were 65.8% and 68%, respectively (P = 0.809). In multivariate analysis, high stage (stage III/IV) alone was an independent prognostic factor for esophageal cancer patients following esophagectomy.

Conclusions: New-onset AF and the other severe complications were not associated with poorer long-term survival following esophagectomy. In addition, administration of landiolol hydrochloride after esophagectomy did not contribute to prolonging the OS.


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