Japan Esophageal Oncology Group of Japan Clinical Oncology Group (JCOG), Tokyo, Japan.
Department of Gastroenterological Surgery, National Hospital Organization Shikoku Cancer Center, 160 Minami-umemoto, Matsuyama, 791-0280, Japan.
Surg Endosc. 2022 Jun;36(6):4275-4282. doi: 10.1007/s00464-021-08768-5. Epub 2021 Oct 26.
Thoracoscopic esophagectomy (TE) is considered the standard surgery for esophageal cancer because of its superiority over open esophagectomy (OE) in terms of short-term outcomes. However, few prospective multicenter studies have evaluated its long-term survival after TE. This study aimed to investigate whether the prognosis for patients with T1bN0M0 esophageal cancer after TE is not inferior to OE using data from the Japan Clinical Oncology Group Study (JCOG0502), a prospective multicenter trial comparing esophagectomy with chemoradiotherapy.
Data of patients in JCOG0502 after esophagectomy were used to compare the overall survival (OS) and relapse-free survival (RFS) after OE versus TE. OE or TE was selected at the surgeon's discretion. A hazard ratio and 95% confidence interval (CI) were calculated via Cox proportional-hazards model.
Of the 210 patients who underwent esophagectomy, 109 underwent OE, whereas 101 underwent TE. The 5-year OS was 88.9% after OE and 85.0% after TE. The hazard ratio of TE for OS was 1.53 (95% CI, 0.84-2.78; p = 0.16) and 1.10 (95% CI, 0.52-2.35; p = 0.80) in the univariable and multivariable analyses, respectively. The 5-year RFS was 85.3% after OE and 79.1% after TE. The hazard ratio of TE for RFS was 1.39 (95% CI, 0.81-2.38; p = 0.23) and 0.88 (95% CI, 0.44-1.74; p = 0.70) in the univariable and multivariable analyses, respectively.
The prognosis for patients with T1bN0M0 esophageal cancer after TE was not inferior to OE.
胸腔镜食管切除术（TE）因其在短期结果方面优于开放性食管切除术（OE），被认为是食管癌的标准手术。然而，很少有前瞻性多中心研究评估 TE 后的长期生存情况。本研究旨在使用日本临床肿瘤学组研究（JCOG0502）的数据，比较 TE 和放化疗的前瞻性多中心试验，来评估 T1bN0M0 食管癌患者 TE 后的预后是否不劣于 OE。
使用 JCOG0502 食管切除术后患者的数据，比较 OE 与 TE 后的总生存期（OS）和无复发生存期（RFS）。OE 或 TE 由外科医生决定。通过 Cox 比例风险模型计算风险比和 95%置信区间（CI）。
210 例接受食管切除术的患者中，109 例行 OE，101 例行 TE。OE 后的 5 年 OS 为 88.9%，TE 后的 5 年 OS 为 85.0%。TE 对 OS 的风险比为 1.53（95%CI，0.84-2.78；p=0.16）和 1.10（95%CI，0.52-2.35；p=0.80），在单变量和多变量分析中分别为。OE 的 5 年 RFS 为 85.3%，TE 的 5 年 RFS 为 79.1%。TE 对 RFS 的风险比为 1.39（95%CI，0.81-2.38；p=0.23）和 0.88（95%CI，0.44-1.74；p=0.70），在单变量和多变量分析中分别为。
TE 后 T1bN0M0 食管癌患者的预后不劣于 OE。
