Comparison of Up-Front Minimally Invasive Esophagectomy versus Open Esophagectomy on Quality of Life for Esophageal Squamous Cell Cancer.

Zhenhua Li,Yonggang Zhu,Shiwang Wen,Yanzhao Xu,Zhen Zhang,Yuefeng Zhang,Ziqiang Tian,Donghui Mu,Huilai Lv,Jingge Cheng

doi:10.3390/curroncol28010068

Abstract

This study investigates whether minimally invasive esophagectomy (MIE) is a safe and effective way for patients with resectable esophageal cancer by comparing the short-term quality of life (QOL) after minimally invasive esophagectomy and open esophagectomy (OE). A total number of 104 patients who underwent esophagectomy from January 2013 to March 2014 were enrolled in this study. These patients were divided into two groups (MIE and OE group). Three scoring scales of quality of life were used to evaluate QOL before the operation and at the first, third, sixth and twelfth months after MIE or OE, which consist of Karnofshy performance scale (KPS), the European Organization for Research and Treatment questionnaire QLQC-30 (EORTC QLQC-30) and esophageal cancer supplement scale (OES-18). The MIE group was higher than the OE group in one-year survival rate (92.54% vs. 72.00%). Significant differences between the two groups were observed in intraoperative bleeding volume (158.53 ± 91.07 mL vs. 228.97 ± 109.33 mL, p = 0.001), and the incidence of postoperative pneumonia (33.33% vs. 58.62%, p = 0.018). The KPS of MIE group was significantly higher than the OE group at the first (80 vs. 70, p = 0.004 < 0.05), third (90 vs. 80, p = 0.006 < 0.05), sixth (90 vs. 80, p = 0.007 < 0.05) and twelfth months (90 vs. 80, p = 0.004 < 0.05) after surgery. The QLQC-30 score of MIE group was better than OE group at first and twelfth months after the operation. The OES-18 score of MIE group was significantly better than OE group at first, sixth and twelfth months after surgery. The short-term quality of life in MIE group was better than OE group.

Highlights

Esophageal cancer was a common type of malignant tumor of the digestive tract, and the incidence rate has increased dramatically over the past years [1]
We enrolled 104 esophageal cancer patients (Table 1). These patients were divided into two groups based on the operative method, minimally invasive esophagectomy (MIE) group and open esophagectomy (OE) group
Both intraoperative bleeding volume and incidence of pneumonia of MIE group were significantly lower than OE group (Table 1)

Summary

Introduction

Esophageal cancer was a common type of malignant tumor of the digestive tract, and the incidence rate has increased dramatically over the past years [1]. It was one of the leading causes for cancer-associated mortality in China, and the incidence and mortality rate of esophageal cancer were ranked 4th in 2015 [2]. The treatment therapies for esophageal cancer include surgery, radiotherapy and chemotherapy, and surgery was regarded as the best option for patients with resectable esophageal cancer [3,4,5]. Postoperative quality of life (QOL) has been a concern for an increasing number of surgeons and patients except survival rates [8]

Methods

Results

Conclusion