{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T16:47:01Z","timestamp":1785689221701,"version":"3.56.0"},"reference-count":26,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T00:00:00Z","timestamp":1671148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Since excessive alcohol consumption is a shared risk factor for esophageal cancer and liver fibrosis, it is possible that patients with esophageal cancer may develop unknown liver fibrosis or cirrhosis. We applied preoperative transient elastography (TE) to patients without recorded cirrhosis undergoing esophagectomy to clarify the validity in predicting postesophagectomy hepatic failure. The cohort consisted of 107 patients who received TE before esophagectomy between June 2018 and December 2021. Patients were categorized into two groups based on the fibrosis score yielded by preoperative TE (mild group: 0~2, n = 92; severe group: 3~4, n = 15). There was no significant difference in demographic data nor surgical variables between the two groups. None of the cohort encountered hepatic failure, yet the severe fibrosis group had a significantly higher rate of pleural effusion (40.0% versus 15.2%, p = 0.03). The areas under the curve (AUCs) of TE in predicting postoperative complications and 180-day mortality were 0.60 (95% CI: 0.46\u20130.74) and 0.67 (95% CI: 0.51\u20130.83), respectively. In conclusion, stratification of patients with esophageal cancer who had liver fibrosis by preoperative TE demonstrates significant validity in predicting postoperative pleural effusions. Recruitment of noncirrhotic patients with higher TE scores is warranted to examine its power in other parameters.<\/jats:p>","DOI":"10.3390\/diagnostics12123194","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T06:58:29Z","timestamp":1671433109000},"page":"3194","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Preoperative Transient Elastography in Patients with Esophageal Cancer"],"prefix":"10.3390","volume":"12","author":[{"given":"Tzu-Yi","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Pang","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Nursing, Yuanpei University of Medical Technology, Hsin-Chu City 300, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Ching","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yi","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8649-8783","authenticated-orcid":false,"given":"Yin-Kai","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7933","DOI":"10.3748\/wjg.v21.i26.7933","article-title":"Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries","volume":"21","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.canep.2016.01.013","article-title":"The epidemic of oesophageal carcinoma: Where are we now?","volume":"41","author":"Thrift","year":"2016","journal-title":"Cancer Epidemiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1038\/ajg.2014.71","article-title":"The synergistic effects of alcohol and tobacco consumption on the risk of esophageal squamous cell carcinoma: A meta-analysis","volume":"109","author":"Prabhu","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/00000658-198707000-00012","article-title":"Results of esophagogastrectomy for carcinoma in cirrhotic patients. A series of 23 consecutive patients","volume":"206","author":"Fekete","year":"1987","journal-title":"Ann. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1245\/s10434-016-5610-8","article-title":"Esophageal Cancer Surgery for Patients with Concomitant Liver Cirrhosis: A Single-Center Matched-Cohort Study","volume":"24","author":"Valmasoni","year":"2017","journal-title":"Ann. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"v50","DOI":"10.1093\/annonc\/mdw329","article-title":"Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"27","author":"Lordick","year":"2016","journal-title":"Ann. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1093\/ejcts\/ezaa334","article-title":"Impact of Child-Pugh class A liver cirrhosis on perioperative outcomes of patients with oesophageal cancer: A propensity score-matched analysis","volume":"59","author":"Cheng","year":"2020","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1097\/SLA.0b013e3182724ce8","article-title":"Value of transient elastography measured with FibroScan in predicting the outcome of hepatic resection for hepatocellular carcinoma","volume":"256","author":"Cescon","year":"2012","journal-title":"Ann. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.5833\/jjgs.25.1201","article-title":"Treatment results of esophageal cancer cases with liver dysfunction","volume":"25","author":"Ohta","year":"1992","journal-title":"Jpn. J. Gastroenterol. Surg."},{"key":"ref_10","first-page":"759","article-title":"Cirrhosis: Diagnosis and Management","volume":"100","author":"Smith","year":"2019","journal-title":"Am. Fam. Physician"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/S0399-8320(08)73994-0","article-title":"Transient elastography (FibroScan)","volume":"32","author":"Vergniol","year":"2008","journal-title":"Gastroenterol. Clin. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_13","first-page":"cd010542","article-title":"Transient elastography for diagnosis of stages of hepatic fibrosis and cirrhosis in people with alcoholic liver disease","volume":"1","author":"Pavlov","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1007\/s11605-016-3083-5","article-title":"Internal and External Validation of a multivariable Model to Define Hospital-Acquired Pneumonia After Esophagectomy","volume":"20","author":"Weijs","year":"2016","journal-title":"J. Gastrointest. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/SLA.0000000000001098","article-title":"International Consensus on Standardization of Data Collection for Complications Associated With Esophagectomy: Esophagectomy Complications Consensus Group (ECCG)","volume":"262","author":"Low","year":"2015","journal-title":"Ann. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1093\/icvts\/ivx132","article-title":"Can oesophagectomy be performed for patients with oesophageal carcinoma and concomitant liver cirrhosis? A retrospective study based on a propensity-matched cohort","volume":"25","author":"Wang","year":"2017","journal-title":"Interact Cardiovasc. Thorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"173421","DOI":"10.1155\/2009\/173421","article-title":"Management of esophageal carcinoma associated with cirrhosis: A retrospective case-control analysis","volume":"2009","author":"Trivin","year":"2009","journal-title":"J. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/bjs.1800600817","article-title":"Transection of the oesophagus for bleeding oesophageal varices","volume":"60","author":"Pugh","year":"1973","journal-title":"Br. J. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1055\/s-2007-1007321","article-title":"Bilirubin metabolism and the hereditary hyperbilirubinemias","volume":"14","author":"Berk","year":"1994","journal-title":"Semin. Liver Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2861","DOI":"10.1002\/bit.27451","article-title":"A mechanobiological mathematical model of liver metabolism","volume":"117","author":"Nikmaneshi","year":"2020","journal-title":"Biotechnol. Bioeng."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/S0083-6729(08)60023-0","article-title":"Metabolism and properties of a liver precursor to prothrombin","volume":"32","author":"Suttie","year":"1974","journal-title":"Vitam. Horm."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1097\/SLA.0b013e318269d2ec","article-title":"Liver stiffness measurement by transient elastography as a predictor on posthepatectomy outcomes","volume":"257","author":"Wong","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/j.surg.2017.06.006","article-title":"Liver stiffness measurement by transient elastography predicts late posthepatectomy outcomes in patients undergoing resection for hepatocellular carcinoma","volume":"162","author":"Rajakannu","year":"2017","journal-title":"Surgery"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1177\/0300060516678525","article-title":"Effectiveness of contrast-enhanced ultrasound and serum liver enzyme measurement in detection and classification of blunt liver trauma","volume":"45","author":"Zhao","year":"2017","journal-title":"J. Int. Med. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1089\/lap.2019.0262","article-title":"Low-Cost Incisionless Liver Retraction for Laparoscopic Sleeve Gastrectomy: A Prospective Controlled Trial","volume":"29","author":"Cal","year":"2019","journal-title":"J. Laparoendosc. Adv. Surg. Technol. A"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1828","DOI":"10.1007\/s00464-018-6461-0","article-title":"A novel liver retraction method in laparoscopic gastrectomy for gastric cancer","volume":"33","author":"Ushimaru","year":"2019","journal-title":"Surg. Endosc."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/12\/3194\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:42:46Z","timestamp":1760146966000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/12\/3194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,16]]},"references-count":26,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["diagnostics12123194"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12123194","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,16]]}}}