Chen Yung-Hsin, Huang Pei-Ming, Chen Ke-Cheng, Lee Jang-Ming
Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100233, Taiwan.
Biomedicines. 2025 Jun 21;13(7):1523. doi: 10.3390/biomedicines13071523.
While minimally invasive esophagectomy is currently accepted as an effective treatment for patients with esophageal cancer, the long-term survival outcomes of single-incision minimally invasive esophagectomy in these patients are still unknown, particularly when compared to those of the more invasive multi-incision minimally invasive esophagectomy. To determine the long-term oncological outcomes of single-incision minimally invasive esophagectomy in patients with esophageal cancer and to compare these outcomes with those of multi-incision minimally invasive esophagectomy. This was a prospective, randomized, and propensity score-matched study wherein we analyzed patients who underwent treatment from February 2005 to May 2022. Our study was carried out by a single surgical team in a tertiary medical center. We analyzed 348 patients with esophageal cancer who underwent single-incision minimally invasive esophagectomy and 469 who underwent multi-incision minimally invasive esophagectomy. We aimed to determine the long-term survival outcomes of single-incision minimally invasive esophagectomy and compare these to those of multi-incision minimally invasive esophagectomy in our study population, and further conducted a propensity score-matching (n = 251 in each arm) study. The disease progression-free (DFS) and overall survival (OS) rates of patients who underwent single-incision minimally invasive esophagectomy (SIMIE) was significantly better than that of those who underwent by multi-incision minimally invasive esophagectomy (MIMIE) ( = 0.024 for OS and = 0.027 for PFS). This trend of difference was observed in the subsequent propensity-score matching analysis ( = 0.009 and 0.016 for OS and PFS, respectively). The single-incision technique applied in minimally invasive esophagectomy to treat esophageal cancer is feasible without compromising the patient's long-term oncological outcome, as opposed to that applied using multi-incision minimally invasive esophagectomy.
虽然微创食管切除术目前被认为是治疗食管癌患者的有效方法，但单切口微创食管切除术治疗这些患者的长期生存结果仍不清楚，特别是与更具侵入性的多切口微创食管切除术相比。为了确定单切口微创食管切除术治疗食管癌患者的长期肿瘤学结果，并将这些结果与多切口微创食管切除术的结果进行比较。这是一项前瞻性、随机、倾向评分匹配研究，我们分析了2005年2月至2022年5月接受治疗的患者。我们的研究由一个单一的手术团队在一家三级医疗中心进行。我们分析了348例行单切口微创食管切除术的食管癌患者和469例行多切口微创食管切除术的患者。我们旨在确定单切口微创食管切除术的长期生存结果，并将其与我们研究人群中的多切口微创食管切除术的结果进行比较，并进一步进行倾向评分匹配（每组n = 251）研究。接受单切口微创食管切除术（SIMIE）的患者的无病进展（DFS）和总生存（OS）率显著优于接受多切口微创食管切除术（MIMIE）的患者（OS为P = 0.024，PFS为P = 0.027）。在随后的倾向评分匹配分析中也观察到这种差异趋势（OS和PFS分别为P = 0.009和0.016）。与多切口微创食管切除术相比，在微创食管切除术中应用单切口技术治疗食管癌是可行的，且不影响患者的长期肿瘤学结果。
