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Minimally Invasive Versus Open McKeown for Patients with Esophageal Cancer: A Retrospective Study

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

McKeown minimally invasive esophagectomy (McKeown-MIE) offers advantages in short-term outcomes compared with McKeown open esophagectomy (McKeown-OE); however, debate as to whether MIE is equivalent or better than OE regarding survival outcomes is ongoing.

Objective

The aim of this study was to compare long-term survival between McKeown-MIE and McKeown-OE in a large cohort of esophageal cancer (EC) patients.

Methods

We used a prospective database (independently managed by LinkDoc company) of the Thoracic Surgery Department at Henan Cancer Hospital and included patients who underwent McKeown-MIE and McKeown-OE for EC from 1 January 2015 to 6 January 2018. The perioperative data and overall survival (OS) rate in the two groups were retrospectively compared.

Results

We included 502 patients who underwent McKeown-MIE (n = 306) or McKeown-OE (n = 196) for EC. The median age in the total patient population was 63 years. All baseline characteristics were well-balanced between the two groups. There was a significantly shorter mean operative time (269.76 min vs. 321.14 min, p < 0.001) in the OE group. The 30-day and in-hospital mortality rates were 0, and there was no difference in 90-day mortality (p = 0.053) between the groups. The postoperative stay was shorter in the MIE group and was 14 days and 18 days in the MIE and OE groups, respectively (p < 0.001). The OS at 60 months was 58.8% and 41.6% in the MIE and OE groups, respectively (p < 0.001) [hazard ratio 1.783, 95% confidence interval 1.347–2.359].

Conclusions

These results showed that McKeown-MIE was associated with better long-term survival than McKeown-OE for patients with resectable EC.

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Funding

This work was supported by the National Natural Science Foundation of China, (NSFC; Grant Number 82002521); Youth Program of the Natural Science Foundation of Henan Province, China (Grant Number 202300410389); Henan Anti-Cancer Association Youth Talent Project, China (Grant Number 2019HYTP018, 2019); and Wu Jieping Medical Foundation (CN), China (Grant Number 320.6750.2020-15-1).

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Author notes

  1. Yan Zheng and Yin Li have contributed equally to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People’s Republic of China

    Yan Zheng MD, PhD, Yin Li MD, PhD, Xianben Liu MD, Haibo Sun MD, PhD, Sining Shen MD, Yufeng Ba MD, Zongfei Wang MD, Shilei Liu MD & Wenqun Xing MD

  2. Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Yin Li MD, PhD

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  1. Yan Zheng MD, PhD
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Correspondence to Wenqun Xing MD.

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Disclosure

Yan Zheng, Yin Li, Xianben Liu, Haibo Sun, Sining Shen, Yufeng Ba, Zongfei Wang, Shilei Liu, and Wenqun Xing indicate no potential relevant conflicts of interest.

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Zheng, Y., Li, Y., Liu, X. et al. Minimally Invasive Versus Open McKeown for Patients with Esophageal Cancer: A Retrospective Study. Ann Surg Oncol 28, 6329–6336 (2021). https://doi.org/10.1245/s10434-021-10105-y

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