OA01.5. Preoperative Assessment of Fitness for Surgery in Patients Planned for Esophagectomy for Cancer, an International Survey to Uncover Current Practices
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ID: 325775
2026
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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer Background Identifying high-risk patients through preoperative assessment of fitness is crucial to mitigate complications after esophagectomy for cancer. However, no international consensus currently exists on which investigations should be included in this assessment. This survey aimed to describe current international practices and explore attitudes towards standardization. Methods An international cross-sectional online survey consisting of 32 questions was conducted between August and November 2025 among specialists involved in the management of patients undergoing esophagectomy for cancer. The questionnaire explored preoperative investigations, decision-making processes, and perspectives on international standardization. An invitation email containing the survey link was distributed to members of the International Society for Diseases of the Esophagus (ISDE). Data were analyzed using descriptive statistics. Results A total of 133 completed questionnaires from 40 countries were analyzed. Most respondents were upper gastrointestinal (62.4%) or thoracic surgeons (25.6%), and 89.5% worked in academic centers. Considerable variability was observed in preoperative assessment strategies. No routine pulmonary function testing was reported in 24.1%, whereas spirometry and diffusion capacity testing were routinely performed in 72.9% and 33.1%, respectively. Echocardiography was routinely used in 52.6%. Routine exercise testing was not performed in 57.9%, whereas stair climbing testing, the 6-minute walk test, and cardiopulmonary exercise testing were used in 20.3%, 18.8%, and 11.3%, respectively. Frailty assessment was reported by 94.7% of respondents, yet standardized screening instruments were used by 20.3%. Prehabilitation programs were systematically initiated in 51.9% of respondents. Notably, 74.4% indicated that preoperative screening should be more standardized internationally. Conclusion This international survey demonstrates substantial variability in preoperative assessment for esophagectomy. The strong support for standardization highlights the demand for international guidelines.
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| Authors | Ward Seurs, Yarno Verbeeck, Hans Van Veer, Stijn Vanstraelen, Philippe Nafteux, Lieven Depypere |
| Journal | diseases of the esophagus : official journal of the international society for diseases of the esophagus |
| Year | 2026 |
| DOI |
10.1093/dote/doag077.010
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| URL | |
| Keywords | Keywords not found |
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