Trial reportAnnals of surgical oncology2023
Safety and Feasibility of Robot-Assisted Minimally Invasive Esophagectomy (RAMIE) with Three-Field Lymphadenectomy and Neoadjuvant Chemoradiotherapy in Patients with Resectable Esophageal Cancer and Cervical Lymph Node Metastasis.
Trial report in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02426879 (Esophagectomy for Patients With Esophageal Cancer and Cervical Lymph Node Metastases Node Study), which is not on this map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Esophagectomy for Patients With Esophageal Cancer and Cervical Lymph Node Metastases Node Study
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Cervical lymph node metastases in thoracic esophageal cancer: a systematic review.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Pooled it
- Intraoperative recurrent laryngeal nerve monitoring in esophagectomy with lymphadenectomy.Journal of thoracic disease · 2026Article
- Treatment strategies of esophageal cancer with concurrent cervical node metastasis: a Dutch nationwide population-based cohort study.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
- Advances in Minimally Invasive Esophagectomy-An Overview of Recent Developments and a Novel Classification of Innovations in Treatment of Thoracic Esophageal Cancer.Medicina (Kaunas, Lithuania) · 2025Review
- Outcomes and predictive factors in post-surgical resection of sT4a esophageal cancer.World journal of surgical oncology · 2025Article
- Effect of cervical paraesophageal lymph node metastasis versus supraclavicular lymph node metastasis on the overall survival of patients with thoracic esophageal squamous cell carcinoma: an observational study.Annals of medicine and surgery (2012) · 2024Article
- Current status and prospects of diagnosis and treatment for esophageal cancer with supraclavicular lymph node metastasis.Frontiers in oncology · 2024Review
- Postesophagectomy Diaphragmatic Prolapse after Robot-Assisted Minimally Invasive Esophagectomy (RAMIE).Journal of clinical medicine · 2023Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the West, patients with cervical lymph node metastasis of resectable esophageal cancer at diagnosis are generally precluded from curative treatment. This study prospectively explored the safety and feasibility of neoadjuvant chemoradiotherapy followed by robot-assisted minimally invasive esophagectomy (RAMIE) with three-field lymphadenectomy for these patients.
methodsBetween 2015 and 2021, patients with resectable thoracic esophageal cancer and cervical lymph node metastasis were recruited nationwide in the Netherlands. Patients without interval metastasis following neoadjuvant chemoradiotherapy and good physical condition underwent RAMIE with bilateral three-field lymphadenectomy. Safety was predefined as ≤50% Clavien-Dindo grade ≥3b postoperative complications.
resultsNeoadjuvant chemoradiotherapy was administered to 29 patients (19 (66%) adenocarcinoma and 10 (34%) squamous cell carcinoma). After restaging, nine (31%) patients were excluded (interval metastasis, clinical deterioration, or withdrawn consent). RAMIE was performed in 20 patients (R0-rate 95%). A median of 42 [range 21-71] lymph nodes were resected of which 13 [range 2-35] were cervical. Only 1 (5%) patient had an unexpected contralateral cervical lymph node metastasis. Complications grade ≥3b occurred in 50%. Most frequent complications of any grade were recurrent laryngeal nerve palsy (45%) and pneumonia (40%). Overall survival at 1 year was 85% and quality of life at 6 months was comparable to esophageal cancer patients treated with curative intent.
conclusionsRAMIE with three-field lymphadenectomy following neoadjuvant chemoradiotherapy for patients with resectable esophageal cancer presenting with cervical lymph node metastasis is feasible in a Western population. Because contralateral cervical metastasis is rare, a unilateral neck dissection would suffice in the majority of cases. CLINICAL TRIAL: gov Identifier: NCT02426879. Dutch trial register Identifier: NTR 4552.
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