Development Pattern on Lymph Node Resection in Minimally Invasive Esophagectomy and 2-year Survival Analysis

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Minimally invasive esophagectomy (MIE) is increasingly used for esophageal cancer.
• The efficacy of MIE, particularly regarding lymph node dissection and patient survival, requires further clarification.

Purpose of the Study:

• To evaluate the learning curve and efficacy of minimally invasive esophagectomy for esophageal cancer.
• To assess the impact of surgeon experience on lymph node dissection and survival outcomes.

Main Methods:

• A retrospective review of 107 patients who underwent MIE between July 2010 and May 2015.
• Patients were divided into three stages based on experience (20, 37, and 50 cases).
• Analysis focused on the number of lymph nodes resected and 2-year survival and disease-free survival rates.

Main Results:

• The mean number of lymph nodes resected significantly increased across the stages (12.65, 15.91, 20.16).
• The proportion of patients with ≥12 or ≥18 lymph nodes dissected also significantly increased.
• No significant differences were observed in 2-year survival or disease-free survival rates between the early stages.

Conclusions:

• Surgeon experience in lymphadenectomy during MIE improves with case volume.
• Approximately 50-60 cases are essential for significant progress in MIE proficiency.
• While lymph node dissection improves, further research is needed to correlate this with long-term survival benefits.