Association between Postoperative Anastomotic Leakage and Dynamic Changes of SII Score in Esophageal Cancer Patients With Neoadjuvant Chemoradiotherapy - A two-center study

ObjectiveTo investigate the correlation between postoperative anastomotic leakage (AOL) and dynamic changes in systemic immune inflammatory index (SII) scores in esophageal cancer patients undergoing neoadjuvant chemoradiotherapy (NAC-CA) after surgery. MethodsA retrospective analysis was conducted on 247 esophageal cancer patients who underwent NAC-CA surgery at Fujian Medical University Union Hospital and Yantai Affiliated Hospital of Binzhou Medical University (two centers) from January 2021 to December 2023. Patients were classified into two groups based on postoperative AOL occurrence: leakage group (38 cases) and non-leakage group (209 cases). The study compared general demographics and dynamic SII scores (preoperative, postoperative day 1, day 3, day 7) between groups, and performed multivariate logistic regression analysis to identify independent risk factors for AOL development. ResultsThe leakage group showed significantly higher rates of age, hypertension prevalence, and dynamic SII scores (especially postoperative day 3) compared to the non-leakage group (P<0.05). The SII score of the leakage group peaked on postoperative day 3 (1897.0{+/-}592.9), which was significantly higher than that of the non-leakage group (1144.5{+/-}316.7) on the same day. Multivariate logistic regression analysis revealed that age (OR=1.05,95% CI=1.02-1.08, P=0.00), hypertension (OR=2.49,95%CI=1.09-5.67, P=0.03), and postoperative day 3 SII score (OR=1.003,95%CI=1.003-1.004, P=0.00) were independent risk factors for AOL. ConclusionDynamic changes of SII scores in esophageal cancer patients undergoing NAC-CA are closely associated with AOL occurrence, and the postoperative day 3 SII score is the most valuable predictor for assessing postoperative leakage risk.