Minimally Invasive
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell
/ pathology
Cohort Studies
Disease-Free Survival
Esophageal Neoplasms
/ pathology
Esophagectomy
/ methods
Esophagogastric Junction
/ pathology
Female
Humans
Laparoscopy
/ methods
Length of Stay
Male
Middle Aged
Minimally Invasive Surgical Procedures
/ methods
Postoperative Complications
/ prevention & control
Propensity Score
Thoracoscopy
/ methods
Treatment Outcome
Esophageal cancer
cancer of the gastroesophageal junction
minimal-invasive esophagectomy
Journal
Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
03
03
2021
revised:
13
05
2021
accepted:
14
05
2021
entrez:
7
7
2021
pubmed:
8
7
2021
medline:
9
7
2021
Statut:
ppublish
Résumé
Esophagectomy is crucial for achieving long-term survival in patients with esophageal cancer, while being associated with a significant risk of complications. Aiming to reduce invasiveness and morbidity, total minimal-invasive esophagectomy (MIE) has been gradually implemented worldwide. The aim of the study was to compare MIE to open Ivor-Lewis esophagectomy (OE) for esophageal cancer or cancer of the gastroesophageal junction (GEJ), in terms of postoperative and oncological outcomes. Clinicopathological data of patients undergoing oncologic transthoracic esophagectomy (Ivor Lewis procedure) between 2010 and 2019 were assessed. Postoperative outcomes and long-term survival of patients undergoing OE were compared to those after MIE using 1:1 propensity score matching. After excluding hybrid and robotic procedures, 90 patients who underwent MIE were compared with a matched cohort of 90 patients who underwent OE. MIE was associated with lower major postoperative morbidity (31% vs. 46%, p=0.046) and lower 90-day mortality (2% vs. 12%, p=0.010) compared to OE. MIE showed non-inferior 3-year overall (65% vs. 52%, p=0.019) and comparable disease-free survival rates (49% vs. 51%, p=0.851) in comparison to OE. Our data suggest that MIE should be preferably performed in patients with esophageal cancer or cancer of the GEJ.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Esophagectomy is crucial for achieving long-term survival in patients with esophageal cancer, while being associated with a significant risk of complications. Aiming to reduce invasiveness and morbidity, total minimal-invasive esophagectomy (MIE) has been gradually implemented worldwide. The aim of the study was to compare MIE to open Ivor-Lewis esophagectomy (OE) for esophageal cancer or cancer of the gastroesophageal junction (GEJ), in terms of postoperative and oncological outcomes.
PATIENTS AND METHODS
METHODS
Clinicopathological data of patients undergoing oncologic transthoracic esophagectomy (Ivor Lewis procedure) between 2010 and 2019 were assessed. Postoperative outcomes and long-term survival of patients undergoing OE were compared to those after MIE using 1:1 propensity score matching.
RESULTS
RESULTS
After excluding hybrid and robotic procedures, 90 patients who underwent MIE were compared with a matched cohort of 90 patients who underwent OE. MIE was associated with lower major postoperative morbidity (31% vs. 46%, p=0.046) and lower 90-day mortality (2% vs. 12%, p=0.010) compared to OE. MIE showed non-inferior 3-year overall (65% vs. 52%, p=0.019) and comparable disease-free survival rates (49% vs. 51%, p=0.851) in comparison to OE.
CONCLUSION
CONCLUSIONS
Our data suggest that MIE should be preferably performed in patients with esophageal cancer or cancer of the GEJ.
Identifiants
pubmed: 34230145
pii: 41/7/3499
doi: 10.21873/anticanres.15137
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3499-3510Informations de copyright
Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.