This thesis explores retrospective and prospective studies aimed at enhancing post-esophageal cancer surgery outcomes. Utilizing extensive patient cohorts from Amsterdam University Medical Center (Amsterdam UMC) and other centers, alongside Dutch Upper GI Cancer Audit (DUCA) database data, the studies focused on optimizing surgical procedures and complication management.In Part One, research centered on predicting surgical outcomes and understanding risk factors related to complications like anastomotic leakage and radiation impact. Key findings included lower leakage rates and shorter hospital stays associated with intrathoracic versus cervical anastomoses, while higher radiation doses correlated with more severe complications. The effect of Body Mass Index (BMI) was examined, revealing that underweight patients faced more postoperative complications than other BMI groups. Stricture development, a significant post-surgery complication, was also analyzed, showing associations with cardiovascular disease and anastomotic leakage.Part Two focused on managing complications post-surgery, including delayed gastric emptying and diaphragmatic hernias. Pneumatic balloon dilation was a safe treatment for gastric emptying issues. Minimally invasive Ivor Lewis procedures presented higher risks for diaphragmatic hernias than open procedures. This thesis also examined micronutrient deficiencies, identifying prevalent shortages in vitamin D, iron, and zinc post-surgery, underscoring the need for vigilant postoperative nutritional monitoring. Overall, the thesis supports refining surgical and postoperative care in order to improve patient outcomes
