COMPARISON OF MINIMALLY INVASIVE ESOPHAGECTOMY WITH AND WITHOUT NEOADJUVANT CHEMOTHERAPY IN THE TREATMENT OF ESOPHAGEAL SQUAMOUS CELL CARCINOMA
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Abstract
Background: Since 2012, the application of neoadjuvant therapy has been recommended in treatment of esophageal cancer. We compared patients who underwent minimally invasive esophagectomy (MIE) with and without neoadjuvant therapy to evaluate the outcomes of the two methods. Methods and Materials: This is a prospective study of esophageal cancer patients in stages cT2-4aN0-3M0 who underwent radical MIE at the Department of Digestive Surgery, Cho Ray Hospital from November 2015 to July 2023. Patients were divided into two groups: those with and without neoadjuvant chemotherapy. Propensity score matching (PSM) was additionally used to improve comparability between the two groups. Results: There were 245 patients. Among them, 84.1% (206/245) received neoadjuvant chemotherapy, and 15.9% (39/245) did not. After matching, each group had 39 patients, and they were similar in terms of age, gender, BMI, PS, preoperative stage, lymphadenectomy level, tumor location, and comorbidities. The neoadjuvant chemotherapy group still had longer operative time (p < 0.001), shorter length of stay (p = 0.023), similar rates of morbidity (p = 0.539), higher 5-year and 8-year OS (p = 0.007), and a trend towards higher 5-year and 8-year DFS (p = 0.055) compared to the surgery non-neoadjuvant group. Conclusions: Compared to non-neoadjuvant, radical MIE after neoadjuvant chemotherapy is safe, feasible, associated with better long-term survival outcomes, and should be widely adopted in the treatment of esophageal cancer.
Article Details
Keywords
minimally invasive esophagectomy, neoadjuvant chemotherapy, esophageal cancer.
References
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