Population-Based Cohort Study from a Prospective National Registry: Better Long-Term Survival in Esophageal Cancer After Minimally Invasive Compared with Open Transthoracic Esophagectomy

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Population-Based Cohort Study from a Prospective National Registry : Better Long-Term Survival in Esophageal Cancer After Minimally Invasive Compared with Open Transthoracic Esophagectomy

Hayami, Masaru (author): Karolinska Univ Hosp, Dept Upper Abdominal Surg, Ctr Digest Dis, Stockholm, Sweden.;Japanese Fdn Canc Res, Canc Inst Hosp, Dept Surg Gastroenterol, Gastroenterol Ctr, Tokyo, Japan.

Ndegwa, Nelson (author): Karolinska Inst, Div Surg, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.

Lindblad, Mats (author): Karolinska Institutet,Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden

Linder, Gustav (author): Uppsala universitet,Gastrointestinalkirurgi,Uppsala Univ, Sweden

Hedberg, Jakob, 1972- (author): Uppsala universitet,Gastrointestinalkirurgi,Uppsala Univ, Sweden

Edholm, David (author): Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US

Johansson, Jan (author): Karolinska Institutet,Skane Univ Hosp, Sweden

Lagergren, Jesper (author): Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Upper Gastrointestinal Surg, Stockholm, Sweden.;Kings Coll London, Sch Canc & Pharmaceut Sci, London, England.

Lundell, Lars (author): Karolinska Inst, Div Surg, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Odense Univ Hosp, Dept Surg, Odense, Denmark.

Nilsson, Magnus (author): Karolinska Institutet,Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden

Rouvelas, Ioannis (author): Karolinska Institutet,Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden

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Karolinska Univ Hosp, Dept Upper Abdominal Surg, Ctr Digest Dis, Stockholm, Sweden;Japanese Fdn Canc Res, Canc Inst Hosp, Dept Surg Gastroenterol, Gastroenterol Ctr, Tokyo, Japan. Karolinska Inst, Div Surg, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden. (creator_code:org_t)

2022-06-25
2022
English.
In: Annals of Surgical Oncology. - : Springer Nature. - 1068-9265 .- 1534-4681. ; 29:9, s. 5609-5621

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; http://kipublication...; https://urn.kb.se/re...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Background Recent research indicates long-term survival benefits of minimally invasive esophagectomy (MIE) compared with open esophagectomy (OE) for patients with esophageal and gastroesophageal junction (GEJ) cancers, but there is a need for more population-based studies. Methods We conducted a prospective population-based nationwide cohort study including all patients in Sweden diagnosed with esophageal or junctional cancer who underwent a transthoracic esophagectomy with intrathoracic anastomosis. Data were collected from the Swedish National Register for Esophageal and Gastric Cancer in 2006-2019. Patients were grouped into OE and MIE including hybrid MIE (HMIE) and totally MIE (TMIE). Overall survival and short-term postoperative outcomes were compared using Cox regression and logistic regression models, respectively. All models were adjusted for age, sex, American Society of Anesthesiologists (ASA) score, clinical T and N stage, neoadjuvant therapy, year of surgery, and hospital volume. Results Among 1404 patients, 998 (71.1%) underwent OE and 406 (28.9%) underwent MIE. Compared with OE, overall survival was better following MIE (hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.55-0.94), TMIE (HR 0.67, 95% CI 0.47-0.94), and possibly also after HMIE (HR 0.76, 95% CI 0.56-1.02). MIE was associated with shorter operation time, less intraoperative bleeding, higher number of resected lymph nodes, and shorter hospital stay compared with OE. MIE was also associated with fewer overall complications (odds ratio [OR] 0.70, 95% CI 0.47-1.03) as well as non-surgical complications (OR 0.64, 95% CI 0.40-1.00). Conclusions MIE seems to offer better survival and similar or improved short-term postoperative outcomes in esophageal and GEJ cancers compared with OE in this unselected population-based cohort.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)

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By the author/editor: Hayami, Masaru; Ndegwa, Nelson; Lindblad, Mats; Linder, Gustav; Hedberg, Jakob, ...; Edholm, David; show more...; Johansson, Jan; Lagergren, Jespe ...; Lundell, Lars; Nilsson, Magnus; Rouvelas, Ioanni ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

Articles in the publication: Annals of Surgic ...

By the university: Uppsala University; Karolinska Institutet; Linköping University

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