Totally minimally invasive esophagectomy after neoadjuvant chemoradiotherapy: Long‐term oncologic outcomes

Background and Objectives Minimally invasive esophagectomy is emerging with comparable short‐term outcomes as open esophagectomies. Neoadjuvant chemoradiotherapy followed by surgery is considered standard of care in the Netherlands for patients with esophageal cancer. The aim of this study was to an...

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Published in:Journal of surgical oncology 2018-03, Vol.117 (4), p.651-658
Main Authors: Lubbers, Merel, van Det, Marc J., Kreuger, Mariska J., Hoekstra, Ronald, Hendriksen, Ellen M., Vermeer, Marloes, Kouwenhoven, Ewout A.
Format: Article
Language:English
Subjects:
Cancer surgery
Chemotherapy
Esophageal cancer
Esophagus
Gastrointestinal surgery
minimally invasive esophagectomy
Mortality
neoadjuvant chemoradiotherapy
Radiation therapy
survival
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Summary:Background and Objectives Minimally invasive esophagectomy is emerging with comparable short‐term outcomes as open esophagectomies. Neoadjuvant chemoradiotherapy followed by surgery is considered standard of care in the Netherlands for patients with esophageal cancer. The aim of this study was to analyze the long‐term oncologic outcome after neoadjuvant chemoradiotherapy followed by totally minimally invasive esophagectomy. Methods Neoadjuvant carboplatin and paclitaxel based chemotherapy was concomitantly given with 41.4 Gy radiotherapy. Six weeks after neoadjuvant treatment, totally minimally invasive esophagectomy was performed. Results From December 2010 until December 2015 161 patients received this combination of treatment. In 128 male and 33 female patients with median age of 65 years (58‐71), 88 minimally invasive esophagectomies with intrathoracic anastomosis and 73 minimally invasive esophagectomies with cervical anastomosis were carried out. Radical (R0) resection was confirmed in 156 patients (97%). In hospital mortality occurred in 6 patients (3.7%). Overall survival was 79% and 51% at 1 and 5 years, respectively, with a median follow‐up of 24.5 months (13‐38). Disease‐free survival was, respectively, 76% and 55%. Conclusions Totally minimally invasive esophagectomy after neoadjuvant chemoradiotherapy for esophageal cancer is a safe treatment with low postoperative mortality rates and favorable overall and disease‐free survival.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.24935