MA20.10 Long-Term Prognostic Factors After Minimally Invasive Esophagectomy (MIE) for Esophageal Cancer

Abstract

MIE has been demonstrated to associate a better peri-operative outcome to treat esophageal cancer as compared to that done by open surgery. However, the long-term clinical impact of MIE and its prognostic factors still requires further clarification. In current study, we evaluated the survival results and the factors influencing the prognosis of patients with esophageal cancer who received total minimally invasive esophagectomy using thoracoscopic and laparoscopic esophagectomy and esophageal reconstruction. A total of 483 patients were included in the study with 179 and 304 receiving Ivor Lewis and McKeown MIE respectively. Neoadjuvant chemoradiation was administered to 379 (78 %) of the patients. The overall and disease progression-free survival curves of all the patients were constructed with five-year survival rates of 48.3% and 40.3% respectively. Multivariate analysis revealed that pathological tumor stage was a significant factor for prognosis after surgery both in the patients treated with and without neoadjuvant CCRT (P< 0.05). Of the patients with patholoigical stage I or ypStage I esopahgeal cancer after CCRT, overall survival was significantly improved with the increased number of dissected lymph nodes (P=0.022). The survival of patients with esophageal cancer undergoing MIE was influenced by their tumor staging, irrespective the use of neoadjuvant CCRT. Of these patients with stage I and ypStage I disease, improved survival can be facilitated with increased number of dissected lymph nodes during MIE.