Minimally Invasive Versus Open McKeown for Patients with Esophageal Cancer: A Retrospective Study
Minimally Invasive Versus Open McKeown for Patients with Esophageal Cancer: A Retrospective Study
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DOI：
10.1245/s10434-021-10105-y
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发表时间：
2021-05-13
影响因子：
3.7
通讯作者：
Xing, Wenqun
中科院分区：
文献类型：
--
作者：
Zheng, Yan;Li, Yin;Xing, Wenqun
与McKeown开放式食管切除术（McKeown-OE）相比，McKeown微创食管切除术（McKeown-MIE）在短期结局方面具有优势;然而，关于MIE在生存结局方面是否等同于或优于OE的争论仍在进行中。目的比较McKeown-MIE和McKeown-OE在食管癌患者中的长期生存率。方法我们使用河南省肿瘤医院胸外科前瞻性数据库（由LinkDoc公司独立管理），纳入2015年1月1日至2018年1月6日接受McKeown-MIE和McKeown-OE治疗EC的患者。回顾性比较两组围手术期资料及总生存率。结果我们纳入了502例接受McKeown-MIE（n = 306）或McKeown-OE（n = 196）治疗EC的患者。总患者人群的中位年龄为63岁。两组之间的所有基线特征都很平衡。OE组的平均手术时间显著更短（269.76 min vs. 321.14 min，p < 0.001）。30天和住院死亡率为0，两组之间的90天死亡率无差异（p = 0.053）。MIE组的术后住院时间较短，MIE组和OE组分别为14天和18天（p < 0.001）。MIE和OE组60个月时的OS分别为58.8%和41.6%（p < 0.001）[风险比1.783，95%置信区间1.347-2.359]。结论对于可切除的食管癌患者，McKeown-MIE比McKeown-OE具有更好的长期生存率。
Introduction McKeown minimally invasive esophagectomy (McKeown-MIE) offers advantages in short-term outcomes compared with McKeown open esophagectomy (McKeown-OE); however, debate as to whether MIE is equivalent or better than OE regarding survival outcomes is ongoing. Objective The aim of this study was to compare long-term survival between McKeown-MIE and McKeown-OE in a large cohort of esophageal cancer (EC) patients. Methods We used a prospective database (independently managed by LinkDoc company) of the Thoracic Surgery Department at Henan Cancer Hospital and included patients who underwent McKeown-MIE and McKeown-OE for EC from 1 January 2015 to 6 January 2018. The perioperative data and overall survival (OS) rate in the two groups were retrospectively compared. Results We included 502 patients who underwent McKeown-MIE (n = 306) or McKeown-OE (n = 196) for EC. The median age in the total patient population was 63 years. All baseline characteristics were well-balanced between the two groups. There was a significantly shorter mean operative time (269.76 min vs. 321.14 min, p < 0.001) in the OE group. The 30-day and in-hospital mortality rates were 0, and there was no difference in 90-day mortality (p = 0.053) between the groups. The postoperative stay was shorter in the MIE group and was 14 days and 18 days in the MIE and OE groups, respectively (p < 0.001). The OS at 60 months was 58.8% and 41.6% in the MIE and OE groups, respectively (p < 0.001) [hazard ratio 1.783, 95% confidence interval 1.347-2.359]. Conclusions These results showed that McKeown-MIE was associated with better long-term survival than McKeown-OE for patients with resectable EC.