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Erschienen in:

19.06.2024 | Thoracic Oncology

Minimally Invasive Esophagectomy Provides Better Short- and Long-Term Outcomes Than Open Esophagectomy in Locally Advanced Esophageal Cancer

verfasst von: Masayoshi Terayama, MD, PhD, Akihiko Okamura, MD, PhD, Kengo Kuriyama, MD, PhD, Naoki Takahashi, MD, Masahiro Tamura, MD, Jun Kanamori, MD, PhD, Yu Imamura, MD, PhD, Masayuki Watanabe, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2024

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Abstract

Background

Minimally invasive esophagectomy (MIE) has been increasingly performed for locally advanced esophageal cancer in place of open transthoracic esophagectomy (OE). This study explored the significance of MIE for esophageal squamous cell carcinoma (ESCC), focusing mainly on the depth of primary esophageal tumors.

Methods

This study retrospectively assessed short- and long-term outcomes of patients who underwent esophagectomy for ESCC from 2005 through 2021. The inverse probability of the treatment-weighting (IPTW) method was used to compare the outcomes between OE and MIE. The outcomes also were evaluated in the subgroups stratified by cT category.

Results

Among 1117 patients, 447 (40%) underwent OE and 670 (60%) underwent MIE. After IPTW adjustment, the incidence of any postoperative complications was significantly higher in the OE group than in the MIE group (60.8% vs 53.7%; p = 0.032), whereas the R0 resection rate was significantly higher in the MIE group (98.6% vs 92.7%; p < 0.001). The MIE group showed better 3 year overall and cancer-specific survival than the OE group (p < 0.001). The incidence of locoregional recurrence within the surgical field was significantly more frequent in the OE group (p < 0.001). In the subgroup analysis stratified by cT category, the R0 resection rate was significantly higher and the incidence of locoregional recurrence was lower in the MIE group among the patients with cT3–4 tumors. In the patients with cT1–2 tumors, MIE showed no significant benefit over OE.

Conclusions

For the patients with cT3–4 tumors, MIE showed fewer postoperative complications, better locoregional control, and better prognosis than OE. Compared with OE, MIE is beneficial, especially for locally advanced ESCC.
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Metadaten
Titel
Minimally Invasive Esophagectomy Provides Better Short- and Long-Term Outcomes Than Open Esophagectomy in Locally Advanced Esophageal Cancer
verfasst von
Masayoshi Terayama, MD, PhD
Akihiko Okamura, MD, PhD
Kengo Kuriyama, MD, PhD
Naoki Takahashi, MD
Masahiro Tamura, MD
Jun Kanamori, MD, PhD
Yu Imamura, MD, PhD
Masayuki Watanabe, MD, PhD
Publikationsdatum
19.06.2024
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2024
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-024-15596-z

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