Evidence map›Paper›PMID 39939552›Full record

ArticleSurgical endoscopy2025

National trends in operative approach to esophagectomy: utilization rates, outcomes, and overall survival.

Lucas Weiser, Claire Perez, Justin J J Watson, Qiudong Chen, Shruthi Nammalwar, Allen Razavi, Charles Fuller, Sevannah G Soukiasian, Andrew R Brownlee, Harmik J Soukiasian

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Lucas WeiserDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA. lucas.weiser@cshs.org.ORCID 0000-0003-2159-6416
Claire PerezDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Justin J J WatsonDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Qiudong ChenDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Shruthi NammalwarDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Allen RazaviDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Charles FullerDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Sevannah G SoukiasianDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Andrew R BrownleeDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
Harmik J SoukiasianDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough open esophagectomies (OE) have traditionally been favored, minimally invasive approaches are increasingly utilized and associated with improved outcomes. We investigated the adoption rates of robotic-assisted minimally invasive esophagectomy (RAMIE) and minimally invasive esophagectomy (MIE) compared with OE. Utilization rates by surgical approach, post-operative outcomes, and overall survival were analyzed.

methodsThe National Cancer Database was queried for patients who underwent OE, MIE, and RAMIE for esophageal cancer from 2010 to 2019. Adoption rates of RAMIE, MIE and OE were determined for all patients. Patients with primary cervical esophageal cancer, stage 4 disease, unknown staging, or missing follow-up data were excluded. Multivariable Cox regression models compared overall survival based on surgical approach.

resultsA total of 17,765 patients underwent an esophagectomy for stage I, II, and III disease (OE: n = 10,039; MIE: n = 5388; RAMIE: n = 2338). Between 2010 and 2019, OE decreased by 52%, while MIE and RAMIE increased by 49% and 704%, respectively. The overall conversion rate of MIE and RAMIE to OE decreased significantly over the study time period. On multivariable analysis, the odds of 30-day and 90-day mortality was lower for MIE (p < 0.001; p < 0.001) and trended towards lower for RAMIE when compared to OE, though was not a statistically significant difference. Further, the overall 5-year survival was higher in the MIE and RAMIE cohort compared to the OE cohort. Like short-term survival, patients who underwent MIE had a significantly lower mortality (p < 0.001) while those who underwent RAMIE trended towards lower mortality.

conclusionThis contemporary review of a national cohort demonstrates the rapid adoption of minimally invasive esophagectomy techniques, without compromise in short-term or long-term outcomes.

Indexed as

Esophageal NeoplasmsEsophagectomyRobotic Surgical ProceduresAgedDatabases, FactualFemaleHumansMaleMiddle AgedNeoplasm StagingRetrospective StudiesTreatment OutcomeUnited StatesEsophageal cancerEsophagectomyMIENCDBRAMIERobotic surgery

Identifiers

PMID39939552

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.