Preoperative Risk Factors and Outcomes in Esophageal Cancer Surgery - Role of Weight, Smoking, and Betel Nut Use

Abstract

Background: Esophageal cancer surgery is associated with considerable morbidity and mortality. Preoperative factors such as nutritional status, smoking, and betel nut chewing may influence postoperative outcomes but remain underexplored in this population. Aim of the study: To evaluate the impact of preoperative weight, smoking history, and betel nut use on postoperative complications and mortality in patients undergoing esophageal cancer surgery. Methods % Materials: A prospective observational study of 70 esophageal cancer patients undergoing surgery was conducted. Baseline demographics, clinical characteristics, and lifestyle habits were recorded. Postoperative complications and outcomes were analyzed. Multivariate logistic regression identified predictors of anastomotic leakage and in-hospital mortality. Result: The mean patient age was 55.5 ± 10.0 years; 77.1% were male. Preoperative weight <45 kg was observed in 40%, smoking history in 47.1%, and betel nut use in 84.3%. Postoperative anastomotic leakage occurred in 12.9%, and in-hospital mortality was 14.3%. Low weight (<45 kg) significantly increased the odds of anastomotic leakage (AOR 3.42, p=0.031) and mortality (AOR 3.78, p=0.048). Betel nut use was also independently associated with higher risk of leakage (AOR 5.25, p=0.040) and mortality (AOR 6.31, p=0.049). Smoking, comorbidities, and neoadjuvant therapy were not significant predictors. Conclusion: Low preoperative weight and betel nut chewing are significant predictors of postoperative complications and mortality in esophageal cancer surgery. Addressing nutritional status and betel nut exposure preoperatively may improve surgical outcomes.