Long-term Survival After Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Nationwide Propensity-score Matched Analysis
| Autor: | Rob H.A. Verhoeven, Suzanne S. Gisbertz, Mark I. van Berge Henegouwen, Laura F C Fransen, Eline M de Groot, Richard van Hillegersberg, Marianne C Kalff, Jelle P. Ruurda, Grard A. P. Nieuwenhuijzen, Misha D. P. Luyer |
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| Přispěvatelé: | Surgery, CCA - Cancer Treatment and quality of life, Internal medicine, APH - Methodology, APH - Quality of Care, CCA - Cancer Treatment and Quality of Life, Other Research, Oncology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Esophageal Neoplasms medicine.medical_treatment survival Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center 0302 clinical medicine Matched cohort Postoperative Complications Long term survival Invasive esophagectomy Medicine Humans Minimally Invasive Surgical Procedures esophageal cancer Propensity Score minimally invasive surgery Retrospective Studies Transhiatal esophagectomy business.industry Background data Esophageal cancer medicine.disease Surgery Esophagectomy Treatment Outcome 030220 oncology & carcinogenesis Propensity score matching 030211 gastroenterology & hepatology business |
| Zdroj: | Annals of Surgery, 276(6), e749-e757. Lippincott Williams and Wilkins Annals of Surgery, 276, E749-E757 Annals of surgery, 276(6), e749-e757. Lippincott Williams and Wilkins Annals of Surgery, 276, 6, pp. E749-E757 Dutch Upper Gastrointestinal Cancer Audit Group 2022, ' Long-term Survival After Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer : A Nationwide Propensity-score Matched Analysis ', Annals of Surgery, vol. 276, no. 6, pp. e749-e757 . https://doi.org/10.1097/SLA.0000000000004708 |
| ISSN: | 0003-4932 |
| DOI: | 10.1097/SLA.0000000000004708 |
| Popis: | OBJECTIVES This study aimed to compare long-term survival following minimally invasive esophagectomy (MIE) versus open esophagectomy (OE) for esophageal cancer using a nationwide propensity-score matched cohort. SUMMARY BACKGROUND DATA MIE provides lower postoperative morbidity and mortality, and similar short-term oncological quality compared to OE. METHODS Data was acquired from the Dutch Upper Gastrointestinal Cancer Audit. Patients undergoing minimally invasive or open, transthoracic or transhiatal esophagectomy for primary esophageal cancer between 2011-2015 were included. A propensity-score matching analysis for MIE versus OE was performed separately for transthoracic and transhiatal esophagectomies. RESULTS A total of 1036 transthoracic MIE and OE patients, and 582 transhiatal MIE and OE patients were matched. Long-term survival was comparable for MIE and OE for both transthoracic and transhiatal procedures (5-year overall survival: transthoracic MIE 49.2% vs. OE 51.1%, p 0.695; transhiatal MIE 48.4% vs. OE 50.7%, p 0.832). For both procedures, MIE yielded more lymph nodes (transthoracic median 21 vs. 18, p < 0.001; transhiatal 15 vs. 13, p 0.007). Post-operative morbidity was comparable after transthoracic MIE and OE (60.8% vs. 64.9%, p 0.177), with a reduced length of stay after transthoracic MIE (median 12 vs. 15 days, p < 0.001). After transhiatal MIE, more postoperative complications (64.9% vs. 56.4%, p 0.034) were observed, without subsequent difference in length of stay. CONCLUSION Long-term survival after minimally invasive esophagectomy was equivalent to open in both propensity-score matched cohorts of patients undergoing transthoracic or transhiatal esophageal resections. Transhiatal minimally invasive esophagectomy was accompanied with more post-operative morbidity. Both transthoracic and transhiatal minimally invasive esophagectomy resulted in a more extended lymphadenectomy. |
| Databáze: | OpenAIRE |
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