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Association Between Liver Fibrosis Assessed by the Aspartate Aminotransferase-To-Platelet Ratio Index and Outcomes of Esophageal Cancer Surgery

  • 0Department of Esophageal Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
World Journal of Surgery +

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July 31, 2025

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July 31, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

High aspartate aminotransferase-to-platelet ratio index (APRI) indicates liver fibrosis and is linked to more complications after esophagectomy, including anastomotic leakage and increased blood loss. This finding highlights APRI as a predictor of surgical outcomes.

Area Of Science

  • Gastroenterology and Hepatology
  • Surgical Oncology
  • Medical Diagnostics

Background

  • Liver cirrhosis is a known risk factor for esophagectomy complications.
  • The impact of liver fibrosis, short of cirrhosis, on surgical outcomes is not well understood.
  • The aspartate aminotransferase-to-platelet ratio index (APRI) is a potential indicator of liver fibrosis.

Purpose Of The Study

  • To investigate the association between preoperative aspartate aminotransferase-to-platelet ratio index (APRI) and surgical outcomes following esophagectomy.
  • To determine if APRI can predict postoperative complications in patients undergoing esophagectomy.

Main Methods

  • Retrospective review of 516 patients who underwent esophagectomy for esophageal cancer.
  • Patients were divided into high (≥0.40) and low (<0.40) APRI groups.
  • Comparison of short- and long-term surgical outcomes between the APRI groups.

Main Results

  • The high APRI group (24.0%) had more males, higher BMI, diabetes, and adenocarcinoma compared to the low APRI group (76.0%).
  • Higher estimated blood loss, anastomotic leakage, and surgical site infection occurred in the high APRI group.
  • High APRI independently predicted increased risk of anastomotic leakage and greater blood loss, and was associated with higher surgical site infection risk.

Conclusions

  • High APRI, indicating liver fibrosis, is associated with increased anastomotic leakage and blood loss after esophagectomy.
  • APRI may serve as a valuable preoperative predictor of adverse surgical outcomes in esophagectomy patients.
  • Overall survival was not significantly different between high and low APRI groups.

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