Back to 2026 Abstracts
Robotic Versus Conventional Minimally Invasive Esophagectomy After Neoadjuvant Therapy In Esophageal Cancer: A Propensity Score Analysis
Yingyi Li1, Tianzheng Shen1, Wenwu He2, Yajie Zhang1, Chengqiang Li1, Yongtao Han2, Chenghao Wang2, Hecheng Li1.
1Shanghai Jiao Tong University School of Medicine Affiliated Ruijin Hospital, Shanghai, China, 2Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.
BACKGROUND:Data on robotic esophagectomy after neoadjuvant therapy, particularly after neoadjuvant immunotherapy, are still lacking. We aimed to compare the outcomes of robot-assisted minimally invasive esophagectomy (RAMIE) versus conventional minimally invasive esophagectomy (MIE) in these patients.
METHODS:Between January 2019 and June 2024, we collected consecutive EC patients who underwent minimally invasive esophagectomy following neoadjuvant chemoradiotherapy (NCRT) or immuno-chemoradiotherapy (NICRT) in two tertiary centers in China (Ruijin Hospital, Shanghai and Sichuan Cancer Hospital, Sichuan). The demographic data and perioperative outcomes were collected and analyzed. Propensity score matching (PSM) was performed on the basis of age, gender, body mass index, performance status score, history of smoking, histology, tumor location, cT and cN stage, neoadjuvant regimen and extent of lymphadenectomy.
RESULTS:After 1:1 matching, 137 patients were included in each group. RAMIE group had more postoperative complications than MIE (52 [38.0%] vs. 34 [24.8%], p = 0.027). Patients underwent RAMIE had a higher proportion of accepting left recurrent laryngeal nerve lymph node dissection compared to MIE (93 [67.9%] vs. 73 [53.3%], p = 0.019). However, there was no significant difference in the operation time (275 [235-315] vs.290 [245-335], p = 0.099), pCR rate(60 [43.8%] vs. 56 [40.9%], p = 0.714), incidence rate of severe postoperative complications(17 [12.4%] vs. 10 [7.3%], p = 0.224), length of hospital stay(14.0 [12.0, 18.0] vs. 14.0 [12.0, 18.0], p = 0.747), 30-day readmission and 90-day mortality. Secondary analysis showed that RAMIE showed no significance in lymph node dissection in patients after NICRT. In patients after NCRT, RAMIE group had shorter operation time (275 [230-325] vs.290 [250-340], p = 0.043) and dissected significantly more lymph nodes of left recurrent laryngeal nerve (mean (SD), 1.6 (2.2) vs. 1.0 (1.5), adjusted p = 0.024).
CONCLUSIONS:Robotic esophagectomy is an equally effective minimally invasive approach for esophageal cancer after NCRT or NICRT in tertiary centers with surgical quality stably reaching contemporary international benchmarks, and its potential advantages in lymph node dissection deserve further investigation.
LEGEND:Table1. Outcomes of robotic versus conventional minimally invasive esophagectomy in patients receiving neoadjuvant chemoradiotherapy and in patients receiving immuno-chemoradiotherapy
Back to 2026 Abstracts
