Reliability and safety of minimally invasive esophagectomy after neoadjuvant chemoradiation: a retrospective study

doi:10.1186/s13019-019-0920-0

. 2019 May 28;14(1):97.

doi: 10.1186/s13019-019-0920-0.

Reliability and safety of minimally invasive esophagectomy after neoadjuvant chemoradiation: a retrospective study

Guangyuan Liu¹, Yongtao Han², Lin Peng², Kangning Wang², Yu Fan³

Affiliations

¹ Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, No.55, Section4, South Renmin Road, Chengdu, 610041, China. liuguangyuan80@163.com.
² Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, No.55, Section4, South Renmin Road, Chengdu, 610041, China.
³ Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, No.55, Section4, South Renmi Road, Chengdu, 610041, China.

PMID: 31138245
PMCID: PMC6537410
DOI: 10.1186/s13019-019-0920-0

Reliability and safety of minimally invasive esophagectomy after neoadjuvant chemoradiation: a retrospective study

Guangyuan Liu et al. J Cardiothorac Surg. 2019.

. 2019 May 28;14(1):97.

doi: 10.1186/s13019-019-0920-0.

Authors

Guangyuan Liu¹, Yongtao Han², Lin Peng², Kangning Wang², Yu Fan³

Affiliations

¹ Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, No.55, Section4, South Renmin Road, Chengdu, 610041, China. liuguangyuan80@163.com.
² Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, No.55, Section4, South Renmin Road, Chengdu, 610041, China.
³ Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, No.55, Section4, South Renmi Road, Chengdu, 610041, China.

PMID: 31138245
PMCID: PMC6537410
DOI: 10.1186/s13019-019-0920-0

Abstract

Background: Thoracic surgeons have recognized the advantages of minimally invasive esophagectomy (MIE). However, MIE for locally advanced esophageal cancer after neoadjuvant chemoradiotherapy (NCRT) is controversial. This study aimed to nvestigate and summarise the reliability and safety of MIE after NCRT.

Methods: We retrospectively analyzed the perioperative outcomes of patients with locally advanced esophageal cancer who underwent minimally invasive esophagectomy after neoadjuvant chemoradiotherapy from January 2016 to January 2018, and compared them with patients who underwent MIE alone during the same period.

Results: In total, 107 patients were eligible for the study. Forty-four patients underwent MIE after NCRT (CRM), and 63 patients underwent MIE alone (MA). The surgical duration (253.59 ± 47.51 vs. 222.86 ± 42.86 min), intraoperative blood loss (164.55 ± 109.09 vs. 146.19 ± 112.89 ml), number of lymph nodes resected (18.36 ± 8.01 vs. 22.10 ± 12.03), duration of the postoperative hospital stay (12.84 ± 6.57 vs. 14.60 ± 8.48 days), postoperative intubation time (5.68 ± 3.08 vs. 6.54 ± 4.97 days), total incidence of complications (34.10% vs. 31.7%), and R0 resection rate (95.45% vs. 96.83%) had no significant difference. The incidence of arrhythmia was higher in CRM (P < 0.02). No mortality occurred postoperatively within 30 days in either group.

Conclusion: Minimally invasive esophagectomy after neoadjuvant chemoradiotherapy is a feasible, safe, and beneficial for postoperative recovery of patients.

Keywords: Esophageal squamous cell carcinoma (ESCC); Locally advanced esophageal cancer; Minimally invasive esophagectomy (MIE); Neoadjuvant chemoradiotherapy (NCRT).

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Conflict of interest statement

The authors declare that they have no competing interests.

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References

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1. Lagergren J, Smyth E, Cunningham D, Lagergren P. Oesophageal cancer. Lancet. 2017;390(10110):2383–2236. doi: 10.1016/S0140-6736(17)31462-9. - DOI - PubMed
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1. Van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, Richel DJ, Nieuwenhuijzen GA, Hospers GA, Bonenkamp JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–2084. doi: 10.1056/NEJMoa1112088. - DOI - PubMed
1. Shapiro J, van Lanschot JJB, Hulshof MCCM, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015;16(9):1090–1098. doi: 10.1016/S1470-2045(15)00040-6. - DOI - PubMed

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[1] Arnold M, Soerjomataram I, Ferlay J, Forman D. Global incidence of oesophageal cancer by histological subtype in 2012. Gut. 2015;64(3):381–387. doi: 10.1136/gutjnl-2014-308124. - DOI - PubMed

[2] Arnold M, Soerjomataram I, Ferlay J, Forman D. Global incidence of oesophageal cancer by histological subtype in 2012. Gut. 2015;64(3):381–387. doi: 10.1136/gutjnl-2014-308124. - DOI - PubMed

[3] Lagergren J, Smyth E, Cunningham D, Lagergren P. Oesophageal cancer. Lancet. 2017;390(10110):2383–2236. doi: 10.1016/S0140-6736(17)31462-9. - DOI - PubMed

[4] Lagergren J, Smyth E, Cunningham D, Lagergren P. Oesophageal cancer. Lancet. 2017;390(10110):2383–2236. doi: 10.1016/S0140-6736(17)31462-9. - DOI - PubMed

[5] Gebskj V, Burmeister B, Smithers BM, et al. Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma:a meta—analysis. Lancet 0ncol. 2007;8(3):226–234. doi: 10.1016/S1470-2045(07)70039-6. - DOI - PubMed

[6] Gebskj V, Burmeister B, Smithers BM, et al. Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma:a meta—analysis. Lancet 0ncol. 2007;8(3):226–234. doi: 10.1016/S1470-2045(07)70039-6. - DOI - PubMed

[7] Van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, Richel DJ, Nieuwenhuijzen GA, Hospers GA, Bonenkamp JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–2084. doi: 10.1056/NEJMoa1112088. - DOI - PubMed

[8] Van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, Richel DJ, Nieuwenhuijzen GA, Hospers GA, Bonenkamp JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–2084. doi: 10.1056/NEJMoa1112088. - DOI - PubMed

[9] Shapiro J, van Lanschot JJB, Hulshof MCCM, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015;16(9):1090–1098. doi: 10.1016/S1470-2045(15)00040-6. - DOI - PubMed

[10] Shapiro J, van Lanschot JJB, Hulshof MCCM, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015;16(9):1090–1098. doi: 10.1016/S1470-2045(15)00040-6. - DOI - PubMed

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Reliability and safety of minimally invasive esophagectomy after neoadjuvant chemoradiation: a retrospective study

Affiliations

Reliability and safety of minimally invasive esophagectomy after neoadjuvant chemoradiation: a retrospective study

Authors

Affiliations

Abstract

Conflict of interest statement

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