Background. Our objective was to determine how surgical approach impacts overall survival and postoperative outcomes when comparing robotic-assisted minimally invasive esophagectomy (RAMIE), minimally invasive esophagectomy (MIE), and open esophagectomy (OE). Methods. The National Cancer Database was queried for patients diagnosed with pathologic Stage 0 to III esophageal cancer from 2010 to 2015. Primary outcome measures evaluated were length of stay, 30-day unplanned readmissions, mortality rates at 30 and 90 days, and overall survival rates. The surgical cohorts underwent 1:1 propensity score matching, and Kaplan-Meier survival estimates were compared by surgical approach. Cox proportional hazards regression was utilized to estimate factors associated with overall survival. Results. Of 5,553 patients that met criteria, 28.4% were MIE, 7.8% RAMIE, and 63.8% OE. From 2010 to 2015, an increasing trend was seen for both minimally invasive approaches, with MIE surpassing the number of OEs. Unplanned 30-day readmissions and 30-day and 90-day mortality rates were not significantly different between the different groups. Median length of stay was significantly

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Despite significant differences in the mean number of nodes examined between medical centers, the overall survival in patients with node-negative colorectal cancer in the 3 medical centers was not statistically different (P =.79). The criterion of examining 14 or more nodes distinguished between individuals at low risk for recurrence and those at increased risk. Conclusions: Variability exists between medical centers in the pathological analysis of colorectal cancer specimens. However, within an institution, examining a mean of 14 or more nodes accurately stages apparently nodenegative colorectal cancer and accurately predicts outcome.

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