Evidence map›Paper›PMID 41663749›Full record

ArticleSurgical endoscopy2026

Does robotic-assisted esophagectomy improve outcomes compared to other techniques? An NCDB analysis of access and disparities.

Claire Perez, Vikram Krishna, Lucas Weiser, Allen Razavi, Kellie Knabe, Sevannah G Soukiasian, Raffaele Rocco, Philicia Moonsamy, Harmik J Soukiasian, Andrew R Brownlee

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Claire PerezDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA. Clairemarie.perez@cshs.org.ORCID http://orcid.org/0009-0000-8581-8773
Vikram KrishnaDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA.
Lucas WeiserDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA.
Allen RazaviDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA.
Kellie KnabeDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA.
Sevannah G SoukiasianDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA.
Raffaele RoccoDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA.
Philicia MoonsamyDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA.
Harmik J SoukiasianDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA.
Andrew R BrownleeDivision of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA, 90048, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSurgery remains the gold standard for non-metastatic esophageal cancer. Oncologic resection is considered adequate when 15 regional lymph nodes are sampled and specimen margins are negative. We hypothesize that racial and regional disparities exist in who receives an adequate oncologic resection.

methodsThe National Cancer Database (NCDB) was queried from 2010 to 2021 for patients who underwent esophagectomy for cancer. Exclusion criteria included stage IV disease and incomplete data. Adequate resection was defined as ≥ 15 lymph nodes removed and negative margins. A multivariable regression model identified factors associated with adequate resection, and survival was assessed using Kaplan-Meier curves.

results11,451 patients were included. Of these, 5153 (45.0%) had an adequate oncologic resection. Black patients had increased odds of an inadequate resection compared to white patients (OR 1.490, 95%CI 1.227-1.809, p < 0.01). Patients treated at community or comprehensive cancer programs had higher odds of inadequate resection than those treated at academic programs. Medicaid patients had higher odds of an inadequate resection compared to those with private insurance (OR 1.397, 95%CI 1.172-1.664, p = < 0.01), while a minimally invasive esophagectomy (MIE) had 24.0% decreased odds of inadequate resection, and robotic-assisted esophagectomy (RAMIE) had 35.4% decreased odds compared to open surgery (95%CI 0.695-0.830, p < 0.01; 95%CI 0.567-0.735, p < 0.01). Controlling for stage, 5-year survival was higher for patients with an adequate resection. Resection adequacy improved from 38.5% in 2010 to 60.1% in 2021, with increases in MIE and RAMIE.

conclusionDisparities persist in who receives adequate resection for esophageal cancer, though overall resection adequacy has improved, these findings should be interpreted in the context of evolving practice patterns.

Indexed as

Esophageal NeoplasmsEsophagectomyHealthcare DisparitiesHealth Services AccessibilityRobotic Surgical ProceduresAgedDatabases, FactualFemaleHumansLymph Node ExcisionMaleMiddle AgedTreatment OutcomeUnited StatesDisparitiesEsophagectomyRobotic-assisted surgery

Identifiers

PMID41663749
PMCPMC13053566

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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.