Very long-term outcomes of minimally invasive esophagectomy for esophageal squamous cell carcinoma.

PURPOSE The most critical parameter in the evaluation of the effectiveness of minimally invasive esophagectomy for esophageal squamous cell carcinoma (SCC) is long-term outcome. In this study, patients in whom more than 5 years had elapsed since they had undergone minimally invasive esophagectomy for esophageal SCC were identified, and the 5-year overall survival (OS) rate and 5-year disease-free survival (DFS) rate were evaluated as the long-term outcomes. METHODS The stage, histology, perioperative complications, recurrence, and survival data were carefully reviewed in 49 patients who underwent minimally invasive esophagectomy for esophageal SCC between January 2008 and January 2010. RESULTS Postoperative 30-day complications were observed in 12 (24.5%) patients. There was no postoperative 30-day mortality. Recurrence was observed in 26 patients (53.1%): of these, 9 (18.4%) developed local recurrence and 14 (28.6%) distant metastasis. Three patients (6.1%) had both local and distant metastases. During the study period, there were 22 (44.9%) deaths, of which 20 were due to cancer and 2 were due to other causes. The patient 5-year OS and DFS rates were 58 and 45%, respectively. CONCLUSION Minimally invasive esophagectomy for the treatment of esophageal SCC is as feasible and safe as open esophagectomy in terms of both very long- and short-term outcomes.