Evaluation of safety profile of thoracoscopic esophagectomy for T1bN0M0 cancer using data from JCOG0502: a prospective multicenter study

Isao Nozaki, Ken Kato, Hiroyasu Igaki, Yoshinori Ito, Hiroyuki Daiko, Masahiko Yano, Harushi Udagawa, Junki Mizusawa, Hiroshi Katayama, Kenichi Nakamura, Yuukou Kitagawa

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Thoracoscopic esophagectomy is rapidly and increasingly being used worldwide because it is a less invasive alternative to open esophagectomy. However, few prospective multicenter studies have evaluated its safety profile. This study aimed to evaluate the safety profile of thoracoscopic esophagectomy using perioperative data from the Japan Clinical Oncology Group Study (JCOG0502). Methods: JCOG0502 is a four-arm prospective study comparing esophagectomy with chemoradiotherapy for esophageal cancer, with randomized and patient preference arms. Patients with clinical stage T1bN0M0 esophageal cancer were enrolled until patient accrual was completed. Open or thoracoscopic esophagectomy was selected at the surgeon’s discretion. Perioperative complications were defined as adverse events of ≥grade 2 as per Common Terminology Criteria for Adverse Events ver. 3.0. Results: A total of 379 patients were enrolled between December 2006 and February 2013. Of the 210 patients who underwent surgery, 109 patients underwent open esophagectomy, and 101 patients underwent thoracoscopic esophagectomy. Although thoracoscopic esophagectomy decreased the incidence of postoperative atelectasis (open: 22.0 %, thoracoscopy: 10.9 %; P = 0.041), reoperation was more frequent in the thoracoscopy group (open: 1.8 %, thoracoscopy: 9.9 %; P = 0.016). The incidence of overall complications did not differ between the two groups (open: 44.0 %, thoracoscopy: 44.6 %; P = 1.00). There was one in-hospital death in each group (open: 0.9 %, thoracoscopy: 1.0 %; P = 1.00). Conclusions: Thoracoscopic esophagectomy is a safe procedure with morbidity and mortality comparable with those of open esophagectomy. However, it is associated with a higher frequency of reoperation.

Original languageEnglish
Pages (from-to)3519-3526
Number of pages8
JournalSurgical Endoscopy and Other Interventional Techniques
Volume29
Issue number12
DOIs
Publication statusPublished - 2015 Dec 1

Keywords

  • Esophageal cancer
  • Esophagectomy
  • Laparoscopy
  • Minimally invasive surgery
  • Reoperation
  • Thoracoscopy

ASJC Scopus subject areas

  • Surgery

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