Lower local recurrence rate after robot-assisted thoracoscopic esophagectomy than conventional thoracoscopic surgery for esophageal cancer

Motoyama, Satoru; Sato, Yusuke; Wakita, Akiyuki; Nagaki, Yushi; Fujita, Hiromu; Sasamori, Ryohei; Kemuriyama, Kohei; Takashima, Shinogu; Imai, Kazuhiro; Minamiya, Yoshihiro

doi:10.1038/s41598-021-86420-x

Cited by 8 publications

(14 citation statements)

References 25 publications

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“…A total of 1027 records were identified after automatically and manually removing duplicate records, and 18 full-text studies met the eligibility criteria for inclusion after the final assessment. [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] The selection strategy and procedure are summarized in the PRISMA flow diagram (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 11 studies analyzed postoperative 90-day mortality in each group. 41,[43][44][45][46][47][48][49][50]52,55 The pooled results of the metaanalysis indicated that there was no significant difference in 90-day mortality between the two groups [0.28% (95% CI: 0%-0.68%) vs 0.66% (95% CI: 0.16%-1.16%); OR = 0.87; 95% CI: 0.40-1.92; P = 0.73]. A low heterogeneity was observed from the synthesized results (I² = 0%; P = 0.92) (Fig.…”

Section: -Day Mortalitymentioning

confidence: 99%

“…In all, 4 studies 40,49,50,52 reported the survival outcomes, with the median survival time ranging from 17 to 39.2 months in the RAMIE group and 9.3 to 41 months in the MIE group. The baseline characteristics of survival analyses are listed in Table 3.…”

Section: Long-term Survivalmentioning

confidence: 99%

“…A total of 4 articles that reported DFS were analyzed, with no HR and 95% CI being reported. 40,49,50,52 Synthesized results of extracted 3-year DFS demonstrated that patients who underwent RAMIE had significantly higher 3-year DFS [77.98% (95% CI: 72.77%-82.43%) vs 70.65% (95% CI: 63.87%-77.00%); OR = 1.42; 95% CI: 1.11-1.83; P = 0.006], and the heterogeneity was low (I² = 0%; P = 0.98) (Fig. 4B).…”

Section: Disease-free Survivalmentioning

confidence: 99%

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Robotic Versus Conventional Minimally Invasive Esophagectomy for Esophageal Cancer

et al. 2022

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Objectives: To give a comprehensive review of the literature comparing perioperative outcomes and long-term survival with robotic-assisted minimally invasive esophagectomy (RAMIE) versus minimally invasive esophagectomy (MIE) for esophageal cancer. Background: Curative minimally invasive surgical treatment for esophageal cancer includes RAMIE and conventional MIE. It remains controversial whether RAMIE is comparable to MIE. Methods: This review was registered at the International Prospective Register of Systematic Reviews (CRD42021260963). A systematic search of databases was conducted. Perioperative outcomes and long-term survival were analyzed and subgroup analysis was conducted. Cumulative meta-analysis was performed to track therapeutic effectiveness. Results: Eighteen studies were included and a total of 2932 patients (92.88% squamous cell carcinoma, 29.83% neoadjuvant therapy, and 38.93% stage III-IV), 1418 underwent RAMIE and 1514 underwent MIE, were analyzed. The number of total lymph nodes (LNs) [23.35 (95% CI: 21.41–25.29) vs 21.98 (95% CI: 20.31–23.65); mean difference (MD) = 1.18; 95% CI: 0.06–2.30; P=0.04], abdominal LNs [9.05 (95% CI: 8.16–9.94) vs 7.75 (95% CI: 6.62–8.88); MD = 1.04; 95% CI: 0.19–1.89; P=0.02] and LNs along the left recurrent laryngeal nerve [1.74 (95% CI: 1.04–2.43) vs 1.34 (95% CI: 0.32–2.35); MD = 0.22; 95% CI: 0.09–0.35; P <0.001] were significantly higher in the RAMIE group. RAMIE is associated with a lower incidence of pneumonia [9.61% (95% CI: 7.38%–11.84%) vs 14.74% (95% CI: 11.62%–18.15%); odds ratio = 0.73; 95% CI: 0.58-0.93; P=0.01]. Meanwhile, other perioperative outcomes, such as operative time, blood loss, length of hospital stay, 30/90-day mortality, and R0 resection, showed no significant difference between the two groups. Regarding long-term survival, the 3-year overall survival was similar in the two groups, whereas patients undergoing RAMIE had a higher rate of 3-year disease-free survival compared with the MIE group [77.98% (95% CI: 72.77%–82.43%) vs 70.65% (95% CI: 63.87%–77.00%); odds ratio = 1.42; 95% CI: 1.11–1.83; P=0.006]. A cumulative meta-analysis conducted for each outcome demonstrated relatively stable effects in the two groups. Analyses of each subgroup showed similar overall outcomes. Conclusions: RAMIE is a safe and feasible alternative to MIE in the treatment of resectable esophageal cancer with comparable perioperative outcomes and seems to indicate a possible superiority in LNs dissection in the abdominal cavity, and LNs dissected along the left recurrent laryngeal nerve and 3-year disease-free survival in particular in esophageal squamous cell carcinoma. Further randomized studies are needed to better evaluate the long-term benefits of RAMIE compared with MIE.

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Section: Resultsmentioning

confidence: 99%

Section: -Day Mortalitymentioning

confidence: 99%

Section: Long-term Survivalmentioning

confidence: 99%

Section: Disease-free Survivalmentioning

confidence: 99%

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Robotic Versus Conventional Minimally Invasive Esophagectomy for Esophageal Cancer

et al. 2022

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“…The treatment center published more than one article with overlapping patients. Motoyama ( 32 ) found that RAMIE could reduce the incidence of recurrence at the surgical site. Long-term outcomes, such as overall survival (OS) and disease-free survival (DFS), must be compared between RAMIE and VAMIE.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted minimally invasive esophagectomy versus video-assisted minimally invasive esophagectomy: a systematic review and meta-analysis

Hao¹,

Liu²,

Peng³

et al. 2021

Transl Cancer Res TCR

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Background Robot-assisted minimally invasive esophagectomy (RAMIE) has been demonstrated to offer realistic three-dimensional visual clarity, flexible movement and so on. The high cost is the main reason hampering universal application. The aim of this study was to compare the short-term outcomes of RAMIE versus video-assisted minimally invasive esophagectomy (VAMIE). Methods The PubMed, EMBASE and Web of Science databases were systematically searched up to June 1, 2021, for studies comparing RAMIE and VAMIE. Results Nineteen studies were enrolled, which consisted of a total of 4,714 patients, including 2,306 patients in the RAMIE group and 2,408 patients in the VAMIE group. In RAMIE patients, higher numbers of total lymph nodes (MD =0.171, 95% CI: 0.086–0.255, P<0.001) and lymph nodes along the left recurrent laryngeal nerve (RLN) (MD =0.219, 95% CI: 0.097–0.340, P<0.001) were removed. In RAMIE patients in the McKown group, higher numbers of total lymph nodes (MD =0.173, 95% CI: 0.080–0.265, P<0.001) and lymph nodes along the left RLN (MD =0.220, 95% CI: 0.090–0.350, P=0.001) were removed, while in those in the ESCC group, higher numbers of total lymph nodes (MD =0.249, 95% CI: 0.091–0.407, P=0.002) and lymph nodes along the left RLN (MD =0.239, 95% CI: 0.102–0.377, P=0.001) were removed. Discussion This study indicated that the main advantage of RAMIE was a greater number of harvested lymph nodes, which may be beneficial to diagnosis and local control. RCTs with larger sample sizes and studies reporting long-term outcomes are needed to evaluate the advantages and disadvantages of RAMIE and VAMIE.

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Treatment of local recurrence of esophageal cancer following Ivor‐Lewis esophagectomy—Experiences of a high‐volume center

Knipper,

Krey,

Lyu

et al. 2024

World j. surg.

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PurposePatients with local recurrence of esophageal cancer have a highly decreased overall survival. There is currently no standardized treatment algorithm for this group. This retrospective cohort study aimed to evaluate the survival of patients with local recurrence, despite receiving individualized treatment options.Methods241 of 1791 patients were diagnosed with a local recurrence following Ivor‐Lewis esophagectomy at the University Hospital of Cologne. 59 patients, who were diagnosed only with a local recurrence of adeno‐ or squamous cell carcinoma and received their individualized therapy regimes at our high‐volume center, were included.ResultsThe study included 52 patients with adenocarcinoma and 7 with squamous cell carcinoma. Among these, 6 patients underwent resection, 19 received solely chemotherapy, 29 received chemoradiotherapy, and 5 were provided with best supportive care. Patients who underwent resection showed a better survival outcome compared to patients without resection (median OS: not reached vs. 15.1 months, p = 0.012). Best supportive care and palliative care were found to be independent risk factors for shorter overall survival compared to curative intended treatment options like local resection or chemoradiotherapy.ConclusionIn this study, different treatment strategies for patients with local recurrence of esophageal cancer were depicted. Resection as well as chemoradiotherapy could play a role in selected patients. Further prospective studies are needed to improve the selection of eligible patients.

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Lower local recurrence rate after robot-assisted thoracoscopic esophagectomy than conventional thoracoscopic surgery for esophageal cancer

Cited by 8 publications

References 25 publications

Robotic Versus Conventional Minimally Invasive Esophagectomy for Esophageal Cancer

Robotic Versus Conventional Minimally Invasive Esophagectomy for Esophageal Cancer

Robot-assisted minimally invasive esophagectomy versus video-assisted minimally invasive esophagectomy: a systematic review and meta-analysis

Treatment of local recurrence of esophageal cancer following Ivor‐Lewis esophagectomy—Experiences of a high‐volume center

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