ASO Author Reflections: The Impact of Minimally Invasive McKeown on Survival in Patients with Resectable Esophageal Cancer

Abstract

Minimally invasive surgery (MIS) has been rapidly adopted in the surgical treatment of all types of cancer since its inception, and there has been no doubt about its better short-term outcome. A main concern of MIS is its oncological appropriateness, which has been demonstrated to be comparable with the conventional open approach in most types of cancer. However, the meta-analysis by Gottlieb-Vedi et al. suggested that long-term survival after minimally invasive esophagectomy (MIE) was better than open esophagectomy (OE). As this was a large-scale study, their conclusions should be convincing. Nonetheless, more studies have shown that MIE was equal to OE. The 3-year results of the TIME trial showed no differences in the oncological outcomes of survival, and the contradictory conclusions soon became a hotspot topic. How do we gain more evidence? Past studies suffered from their small sample size and hybrid MIE, while the ongoing randomized controlled trial (RCT) suffered from long-term recruitment and long-term follow-up in regions with a low incidence rate, especially in Western countries. PRESENT