Safety and feasibility of thoracoscopic esophagectomy after neoadjuvant chemotherapy for esophageal cancer

• Published in: Surgery today (Tokyo, Japan) Vol. 47; no. 11; pp. 1356 - 1360
• Main Authors: Fujiwara, Yushi, Lee, Shigeru, Kishida, Satoru, Hashiba, Ryoya, Gyobu, Ken, Takemura, Masashi, Osugi, Harushi
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.11.2017
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Esophageal Neoplasms - therapy; Esophagectomy; Feasibility Studies; Female; Fluorouracil - administration & dosage; Humans; Lymph Node Excision; Male; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy; Neoplasm Staging; Original Article; Retrospective Studies; Safety; Surgery; Surgical Oncology; Thoracoscopy; Treatment Outcome; Neoadjuvant chemotherapy; Thoracoscopic esophagectomy; Esophageal carcinoma
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-017-1526-6

Purpose Neoadjuvant chemotherapy (NAC) with cisplatin and fluorouracil is the recommended standard treatment for resectable locally advanced esophageal cancer (EC) in Japan. We investigated the effects of NAC on the safety and feasibility of thoracoscopic esophagectomy with total mediastinal lymphadenectomy for EC. Methods This retrospective study analyzed data from 225 consecutive patients who underwent thoracoscopic esophagectomy with lymph node dissection between April 2007 and December 2015. Patients with clinical stage IB, IIA, IIB, IIIA, or IIIB EC, and no active concomitant malignancy were included. We compared intraoperative outcomes, and postoperative morbidity and mortality between patients who received NAC ( n  = 139; NAC group) and patients who did not ( n  = 86; non-NAC group). Results Preoperative laboratory data revealed that anemia, thrombopenia, and renal dysfunction were more common in the NAC group than in the non-NAC group. There were no differences between the groups in operating times, blood loss, number of dissected lymph nodes, overall complication rates, or length of postoperative hospital stay. Conclusion Based on our findings, thoracoscopic esophagectomy is safe and effective for locally advanced EC, even after NAC.