OGC SO39 - The OUTLIVE Study - Oesophageal and JUncTional Cancer ELectIVE Surgery Morbidity and Mortality at 90-Day: A TUGS Multinational Audit

Abstract Background Oesophageal cancers are among the most common types of cancer and have a high mortality rate. Todate, oesophagectomy remains the gold standard treatment. However, considerable heterogeneity in the literature fails to generate a truly representative picture of short-term outcomes associated with these procedures. Method This multinational global audit includes all consecutive adults with clinically documented primary oesophageal malignancy undergoing elective surgery with curative intent. The study'sstudy's primary objective was to assess the 90-day mortality and morbidity rates in this population. Data was collected through a standardised dataset, and a descriptive analysis was employed. For analysis purposes, the patients were classified depending on the surgical procedure they underwent (laparoscopic, open, hybrid, converted and robotic surgery). Results A total of 622 individuals were analysed, most male [462 (74%)], with a mean Charlson Comorbidity Index of 4.30. The most common procedure was laparoscopic surgery [222 (35.7%)], followed by open surgery [198 (31.83%)]. 31 (5%) of the procedures reported an intraoperative complication, but more common in open procedures [11 (5.6%)]. 318 (51%) patients suffered postoperative complications within 90 days of surgery. The reoperation rate was 9.3%. McKeown staged procedure, compared to Ivor Lewis, had more infective complications [19% vs 11%, p=0.007] and a higher conversion to open procedures [69 (11.1%)]. 34 (11%) patients died because of a surgical complication. Conclusion No significant differences were found between the number of patients with at least one complication and the surgical approach. Nevertheless, robotic-assisted minimally invasive oesophagectomy (RAMIE) presented with the lowest complication, reoperation, and mortality rates. McKeown three-stage surgery also presented with worse clinical outcomes compared to Ivor Lewis procedures. Further studies and randomised control trials comparing different procedures in the field of elective oesophagectomy are needed to expand our knowledge in this field and guarantee the best outcomes for our patients.