Risk factors associated with postoperative mortality in patients with esophageal cancer.

We examined how impaired host defense mechanisms contribute to fatal complications following transthoracic esophagectomy for malignancy, and compared them with other risk factors. Risks associated with operative mortality were categorized into 5 groups. Twelve of 80 patients had postoperative fatal complications. Five variables in the category of impaired defense mechanisms predicted fatal complications with an accuracy of 86.3%. The accuracy of prediction by preoperative vital organ dysfunction, other preoperative risks, intraoperative risks, and perioperative risks was 87.3%, 90.0%, 87.5%, and 85.0%, respectively. When the 5 groups of risk variables were considered together, the accuracy increased to 93.8%. We conclude that impaired defense mechanisms are one of the important risk factors that contribute to postoperative fatal complications and should be considered with other risk factors when predicting mortality of transthoracic esophagetcomy.