Universität zu Köln

Hoelscher, Arnulf H., DeMeester, Tom R., Schmidt, Henner, Berlth, Felix and Bollschweiler, Elfriede (2020). Propensity score-matched comparison between open and minimal invasive hybrid esophagectomy for esophageal adenocarcinoma. Langenbecks Arch. Surg., 405 (4). S. 521 - 533. NEW YORK: SPRINGER. ISSN 1435-2451

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Abstract

Background This study compared the outcome between patients who had an open and those who had a hybrid esophagectomy for T1 or T3 esophageal adenocarcinoma (eAC). No clear data are available concerning this question based on T-category. Methods Two groups of patients with esophagectomy and high intrathoracic esophagogastrostomy for eAC were analyzed: hybrid (laparoscopy + right thoracotomy) (n = 835) and open (laparotomy + right thoracotomy) (n = 188). Outcome criteria were 30- and 90-day mortality, R0-resection rate (R0), number of resected lymph nodes (rLNs), and 5-year survival rate (5y-SR). For each type of surgery, three patient groups were analyzed: pT1-carcinoma (group-1), cT3Nx and neoadjuvant chemoradiation (group-2), and pT3N0-3 without neoadjuvant therapy (group-3). The comparison was based on a propensity score matching in relation of 1:2 for open versus hybrid. Results In group-1 (38 open vs 76 hybrid) R0-resection (100%), 30-day mortality (0%), 90-day mortality (2.6% vs 0%), and rLNs (median 29.5 vs 28.5) were not significantly different. The pN0-rate was 76% in the open and 92% in the hybrid group (p = 0.036). Accordingly, the 5y-SR was 69% and 87% (p = 0.016), but the prognosis of the subgroups pT1pN0 or pT1pN+ was not significantly different between open or hybrid. In group-2 (68 open vs 135 hybrid) R0-resection (97%), 30-day (0% vs 0.7%) and 90-day (4%) mortality, rLNs (28.5 vs 26), and 5y-SR (36% vs 41%) were not significantly different. In group-3 (37 open vs 75 hybrid) R0, postoperative mortality, rLNs, and 5y-SR were not significantly different. Conclusion In a propensity score-matched comparison of patients with an open or hybrid esophagectomy for esophageal adenocarcinoma the quality of oncologic resection, postoperative mortality and prognosis are not different.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hoelscher, Arnulf H. UNSPECIFIED UNSPECIFIED UNSPECIFIED DeMeester, Tom R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Henner UNSPECIFIED UNSPECIFIED UNSPECIFIED Berlth, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollschweiler, Elfriede UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-334137
DOI:	10.1007/s00423-020-01882-3
Journal or Publication Title:	Langenbecks Arch. Surg.
Volume:	405
Number:	4
Page Range:	S. 521 - 533
Date:	2020
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1435-2451
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language IVOR LEWIS ESOPHAGECTOMY; CANCER; SURVIVAL Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33413