Guo Feng, Duan Xiaofeng
Department of Endoscopy Diagnosis and Therapy, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Department of Minimally Invasive Esophageal Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
Surg Endosc. 2025 Aug 6. doi: 10.1007/s00464-025-12043-2.
The aim of this study was to explore the advantages of robot-assisted esophagectomy (RAE) over video-assisted esophagectomy (VAE) for locally advanced esophageal squamous cell carcinoma (ESCC) after neoadjuvant chemoradiotherapy (NCRT).
A retrospective analysis was conducted on clinical data for patients with locally advanced ESCC (cT2-4aN0-3M0) who underwent NCRT from January 2015 to December 2021. Kaplan-Meier survival curves for univariate survival analysis and Cox regression analysis for multivariate survival analysis were used to compare overall (OS) and disease-free survival (DFS).
Ninety-five patients (59.3 ± 7.1 years) were included in the study, including 65 with VAE and 30 with RAE. There were no significant differences in surgical time, bleeding volume, or the number of lymph node dissections between the two groups (P > 0.05). The incidence of postoperative complications, length of hospital stay, and intensive care unit readmission rate were similar between the two groups (P > 0.05). Eighty-eight patients were followed up with a median follow-up time of 30 (4-93) months. The 1-year and 3-year OS in the RAE group were 93.1% and 73.5%, respectively, while the 1-year and 3-year OS in the VAE group were 81.4% and 52.5%, respectively (P = 0.046). Cox multivariate analysis showed that ypTNM staging was an independent prognostic factor for OS (P = 0.031) and DFS (P = 0.049).
The short-term clinical outcomes of RAE for locally advanced ESCC after NCRT are satisfactory, and the long-term survival is not inferior to that of VAE.
本研究旨在探讨新辅助放化疗（NCRT）后，机器人辅助食管癌切除术（RAE）相对于电视辅助食管癌切除术（VAE）治疗局部晚期食管鳞状细胞癌（ESCC）的优势。
对2015年1月至2021年12月期间接受NCRT的局部晚期ESCC（cT2-4aN0-3M0）患者的临床资料进行回顾性分析。采用Kaplan-Meier生存曲线进行单因素生存分析，Cox回归分析进行多因素生存分析，以比较总生存期（OS）和无病生存期（DFS）。
本研究纳入95例患者（59.3±7.1岁），其中65例行VAE，30例行RAE。两组患者的手术时间、出血量或淋巴结清扫数量无显著差异（P>0.05）。两组患者术后并发症发生率、住院时间和重症监护病房再入院率相似（P>0.05）。88例患者获得随访，中位随访时间为30（4-93）个月。RAE组1年和3年OS分别为93.1%和73.5%，而VAE组1年和3年OS分别为81.4%和52.5%（P=0.046）。Cox多因素分析显示，ypTNM分期是OS（P=0.031）和DFS（P=0.049）的独立预后因素。
NCRT后RAE治疗局部晚期ESCC的短期临床疗效满意，长期生存不劣于VAE。
