Original articleGeneral thoracicOutcomes With Open and Minimally Invasive Ivor Lewis Esophagectomy After Neoadjuvant Therapy
Section snippets
Patients
The study population included 130 consecutive patients undergoing Ivor Lewis esophagectomies with curative intent after having received neoadjuvant therapy at the Massachusetts General Hospital between January 2008 and December 2012. Operations performed with an open or MIE approach were included. All patients were evaluated with computed tomography of the chest, abdomen and pelvis. Most patients underwent staging with positron emission tomography and endoscopic ultrasound, if feasible.
Baseline Characteristics
There were 74 patients (56.9%) receiving an open Ivor Lewis esophagectomy and 56 (43.1%) who underwent MIE after neoadjuvant therapy. Baseline patient characteristics are reported in Table 1. Patients in the open and MIE groups were comparable in gender, age, smoking history, body mass index, comorbidities, and preoperative pulmonary function tests. However, patients in the MIE group presented more frequently with a history of chronic obstructive pulmonary disease, and patients in the open
Comment
Patients with locally advanced esophageal cancer should be evaluated in a multidisciplinary fashion and considered for neoadjuvant therapy, regardless of the planned surgical approach to resection 12, 13, as currently strongly recommended by clinical practice guidelines for the management of esophageal cancer [14], including those published by The Society of Thoracic Surgeons [4]. Therefore, an increase is expected in the number of patients presenting for esophagectomy who have received
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