Evidence map›Paper›PMID 40116900›Full record

ArticleSurgical endoscopy2025

Short-and middle-term outcomes of robot-assisted minimally invasive esophagectomy for highly locally advanced esophageal cancer with stage cT3 borderline and cT4b at initial diagnosis.

Takeo Fujita, Kazuma Sato, Daisuke Kajiyama, Yuto Kubo, Naoto Fujiwara, Hiroyuki Daiko

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 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
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

6 authors.

Takeo FujitaDivision of Esophageal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. takfujit@east.ncc.go.jp.ORCID http://orcid.org/0000-0002-6098-9813
Kazuma SatoDivision of Esophageal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Daisuke KajiyamaDivision of Esophageal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Yuto KuboDivision of Esophageal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Naoto FujiwaraDivision of Esophageal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Hiroyuki DaikoDivision of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough the efficacy of robot-assisted minimally invasive esophagectomy (RAMIE) in locally advanced esophageal cancer has been suggested, solid evidence is lacking. In this study, we examined the short- and middle-term outcomes of RAMIE in patients with highly locally advanced esophageal cancer who were initially diagnosed with cT3 borderline resectable or cT4b (cT3br/cT4b) disease and deemed resectable after preoperative treatment. Furthermore, we compared the short- and middle-term outcomes of RAMIE with conventional minimally invasive esophagectomy (cMIE).

methodsEighty-one patients with locally advanced initial T3br and T4 esophageal squamous cell carcinoma previously treated with chemotherapy or chemoradiation underwent minimally invasive esophagectomy with curative intent between 2018 and 2022. We then examined the short- and long-term outcomes of RAMIE compared with cMIE in patients initially diagnosed with stage cT3br/cT4b disease.

resultsAmong these 81 patients, 33 underwent RAMIE and 48 underwent cMIE. The average age of the 81 patients was 65.8 years, with tumors located primarily in the mid-esophagus (55.6%). Most patients initially had stage cT3br (56.8%) or cT4b (43.2%) disease, with 88.9% showing invasion near the trachea or bronchus. No significant differences were observed between the cMIE and RAMIE groups for operation time, blood loss, or common postoperative complications. However, the RAMIE group had a lower incomplete resection rate vs the cMIE group (9.0% vs 16.6%, respectively). The 3-year overall survival rate was 63.1%, with RAMIE showing slightly better survival rates compared with cMIE (p = 0.032). The prognostic factors in the RAMIE group indicated better outcomes for single-organ vs multiple-organ invasion (p = 0.036) and patients with a higher histological response (p = 0.048).

conclusionRAMIE may offer improved outcomes for highly locally advanced esophageal cancer, such as patients with stage T3br or T4b disease. Future studies that analyze data for high numbers of cases in multiple facilities are needed.

Indexed as

Esophageal NeoplasmsEsophageal Squamous Cell CarcinomaEsophagectomyRobotic Surgical ProceduresAgedFemaleHumansMaleMiddle AgedMinimally Invasive Surgical ProceduresNeoplasm StagingRetrospective StudiesTreatment OutcomeConversion esophagectomycT3 borderlinecT4bEsophagectomyRobotic surgery

Identifiers

PMID40116900

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.