Right versus left thoracic approach esophagectomy for patients with neoadjuvant immunochemotherapy
Background The purpose of this study was to investigate the safety and efficacy of left thoracic approach (LTA) and right thoracic approach (RTA) in patients with esophageal squamous cell carcinoma (ESCC) after neoadjuvant immunochemotherapy (NICT).Methods This study included 83 ESCC patients who un...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2456691 |
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| author | Kexi Wang Xuan Xie Jianqun He Shuogui Fang Yiming Zhong Duoguang Wu Kefeng Wang Minghui Wang |
| author_facet | Kexi Wang Xuan Xie Jianqun He Shuogui Fang Yiming Zhong Duoguang Wu Kefeng Wang Minghui Wang |
| author_sort | Kexi Wang |
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| description | Background The purpose of this study was to investigate the safety and efficacy of left thoracic approach (LTA) and right thoracic approach (RTA) in patients with esophageal squamous cell carcinoma (ESCC) after neoadjuvant immunochemotherapy (NICT).Methods This study included 83 ESCC patients who underwent right transthoracic esophagectomy (n = 61) and left transthoracic esophagectomy (n = 22) after NICT in our hospital from October 2019 to September 2023. The data of these patients were retrospectively analyzed.Results Compared with the LTA group, the RTA group had a longer operation time (245.6 ± 27.8 min vs. 356.5 ± 83.2 min, p < 0.001) and more lymph nodes were removed (21.0 ± 7.9 vs. 29.3 ± 10.8, p = 0.001). The 3-year disease free survival (DFS) of the LTA group and the RTA group were 61.0% and 65.7% (p = 0.861), and the 3-year overall survival (OS) were 60.7% and 77.4% (p = 0.753) respectively. There was no significant difference in prognosis between the two groups. Lymphovascular invasion was an independent risk factor for DFS (HR = 4.042, p = 0.004) and OS (HR = 4.607, p = 0.003) in patients with ESCC undergoing NICT combined with surgery.Conclusion There was no difference in postoperative complications and short-term survival in patients with ESCC underwent surgery after NICT regardless of left or right thoracic approach. It is worth noting that lymphovascular invasion has an important impact on the prognosis of these patients. |
| format | Article |
| id | doaj-art-4a733e46504042268dc4d6443762a1c3 |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-4a733e46504042268dc4d6443762a1c32025-01-25T14:38:22ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2456691Right versus left thoracic approach esophagectomy for patients with neoadjuvant immunochemotherapyKexi Wang0Xuan Xie1Jianqun He2Shuogui Fang3Yiming Zhong4Duoguang Wu5Kefeng Wang6Minghui Wang7Department of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, ChinaBackground The purpose of this study was to investigate the safety and efficacy of left thoracic approach (LTA) and right thoracic approach (RTA) in patients with esophageal squamous cell carcinoma (ESCC) after neoadjuvant immunochemotherapy (NICT).Methods This study included 83 ESCC patients who underwent right transthoracic esophagectomy (n = 61) and left transthoracic esophagectomy (n = 22) after NICT in our hospital from October 2019 to September 2023. The data of these patients were retrospectively analyzed.Results Compared with the LTA group, the RTA group had a longer operation time (245.6 ± 27.8 min vs. 356.5 ± 83.2 min, p < 0.001) and more lymph nodes were removed (21.0 ± 7.9 vs. 29.3 ± 10.8, p = 0.001). The 3-year disease free survival (DFS) of the LTA group and the RTA group were 61.0% and 65.7% (p = 0.861), and the 3-year overall survival (OS) were 60.7% and 77.4% (p = 0.753) respectively. There was no significant difference in prognosis between the two groups. Lymphovascular invasion was an independent risk factor for DFS (HR = 4.042, p = 0.004) and OS (HR = 4.607, p = 0.003) in patients with ESCC undergoing NICT combined with surgery.Conclusion There was no difference in postoperative complications and short-term survival in patients with ESCC underwent surgery after NICT regardless of left or right thoracic approach. It is worth noting that lymphovascular invasion has an important impact on the prognosis of these patients.https://www.tandfonline.com/doi/10.1080/07853890.2025.2456691Neoadjuvant chemoimmunotherapytransthoracic approachesophageal squamous cell carcinomaleft transthoracic approachright transthoracic approach |
| spellingShingle | Kexi Wang Xuan Xie Jianqun He Shuogui Fang Yiming Zhong Duoguang Wu Kefeng Wang Minghui Wang Right versus left thoracic approach esophagectomy for patients with neoadjuvant immunochemotherapy Annals of Medicine Neoadjuvant chemoimmunotherapy transthoracic approach esophageal squamous cell carcinoma left transthoracic approach right transthoracic approach |
| title | Right versus left thoracic approach esophagectomy for patients with neoadjuvant immunochemotherapy |
| title_full | Right versus left thoracic approach esophagectomy for patients with neoadjuvant immunochemotherapy |
| title_fullStr | Right versus left thoracic approach esophagectomy for patients with neoadjuvant immunochemotherapy |
| title_full_unstemmed | Right versus left thoracic approach esophagectomy for patients with neoadjuvant immunochemotherapy |
| title_short | Right versus left thoracic approach esophagectomy for patients with neoadjuvant immunochemotherapy |
| title_sort | right versus left thoracic approach esophagectomy for patients with neoadjuvant immunochemotherapy |
| topic | Neoadjuvant chemoimmunotherapy transthoracic approach esophageal squamous cell carcinoma left transthoracic approach right transthoracic approach |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2456691 |
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