BACKGROUND

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).

METHODS

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).

RESULTS

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).

CONCLUSIONS

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.