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September 10, 2025

Survival and Oncological Outcomes of Esophageal Cancer Following Minimally Invasive Esophagectomy: A Single-Centre Experience

Key Points

Survival rates at 1, 2, and 3 years post minimally invasive esophagectomy were 76.1%, 49.1%, and 32.7%, respectively.
Eighty-four percent of patients received neoadjuvant therapy prior to esophagectomy, suggesting comprehensive treatment strategies.
The majority of patients had advanced cancer stages, indicating that minimally invasive surgery offers a viable option for improving outcomes.
Disease recurrence was noted in 21% of patients, highlighting the need for ongoing research into optimal selection criteria.

Abstract

Abstract Background Esophageal cancer is associated with high morbidity with overall 5-year survival reported at less than 20%. Although substantial improvements in multimodal therapy have been achieved, the all-stage mortality rate of esophageal cancer is still among the highest, with a reported 5-year survival between 10% and 25%. To reduce surgery-associated morbidity and mortality, minimally invasive esophagectomy (MIE) has been introduced since 2020 in our centre. These short-term advantages could suggest improved long-term survival benefits. Methods A retrospective analysis of prospectively collected data on patients who underwent MIE for esophageal cancer between 2020 and 2024 at a Esophagogastric Cancer Centre in Northern Malaysia. Patient demographics, cancer stage, treatment strategies and oncological outcomes were reviewed. Overall-survival (OS) and disease-free survival (DFS) were analyzed by Kaplan–Meier estimates and log-rank test was used to assess survival differences between groups. Results A total-of-51 patients underwent MIE. Majority has good ECOG-performance status (90%). Neoadjuvant-therapy was administered to 84.3% of patients. 90.2% of patients underwent total-thoraco-laparoscopic surgery. Majority were predominantly pathological stage III (47.1%) and IVa (27.5) respectively.R0-resection was achieved in 83% of patients in the neoadjuvant therapy group. The mean harvested lymph-node was 42.8 ± 20.1 with mean positive lymph-node 3.9 ± 4.7. 81% of patients completed adjuvant-therapy. Tumor recurrence was observed in 21% of the patients.Patient OS and DFS at 1,2,3-years following MIE was 76.1%, 49.1%, 32.7% and 96.9%, 62.6% and 47.0% respectively. Conclusion MIE offers promising long-term survival outcomes for esophageal cancer patients, with potential advantages over traditional open esophagectomy, especially in locally advanced cases. However, challenges such as disease recurrence and optimal patient selection criteria warrant further investigation. Ongoing research and long term follow-up are essential to focus on identifying prognostic factors to improve survival.

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