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Background <p>To evaluate the initial site of recurrence in patients with esophageal squamous cell carcinoma who underwent robot-assisted mediastinoscopic minimally invasive esophagectomy (RA-mMIE).</p> Methods <p>Patients who underwent RA-mMIE for thoracic esophageal squamous cell carcinoma between January 2012 and December 2023 were enrolled. The first site of recurrence was defined as the recurrent site classified into seven regions: inside the thoracic surgical field (ITSF), outside the thoracic surgical field (OTSF), inside the cervix (IC), supraclavicular (SC), inside the abdominal surgical field (IASF), outside the abdominal surgical field (OASF), and distant organs (DO).</p> Results <p>In total, 237 patients who underwent RA-mMIE were included in the analysis. Recurrence occurred in 66 (27.4%) patients. ITSF recurrence occurred in 22 (9.3%), OTSF in 22 (9.3%), IC in 3 (1.2%), SC in 11 (4.6%), IASF in 4 (1.7%), OASF in 8 (3.4%), and DO in 23 (9.7%). Solitary ITSF recurrence was observed in 1.0% (1/95), 4.2% (3/71), 8.9% (5/26), and 6.7% (1/15) of patients with cStages I, II, III, and IV, respectively. In cumulative incidence function analyses, cT and cN categories, clinical ITSF lymph node metastasis, pT category, radial margin positivity, and pathological ITSF lymph node metastasis were significantly associated with ITSF recurrence. In multivariate Fine–Gray proportional subdistribution hazard regression analyses, both cT (≥ 3) and pT (≥ 3) remained significant independent factors.</p> Conclusions <p>The ITSF recurrence rate after RA-mMIE was comparable to previously reported data, indicating that oncological radicality of RA-mMIE is sufficient in terms of local control capability.</p>

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Recurrence patterns of robot-assisted mediastinoscopic minimally invasive esophagectomy in patients with thoracic esophageal squamous cell carcinoma

  • 期刊论文

  • 发表日期：

    2026年3月4日

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  • Koichi Yagi,
  • Shoh Yajima,
  • Susumu Aikou,
  • Kotaro Sugawara,
  • Raito Asaoka,
  • Yasuyoshi Sato,
  • Shuichiro Oya,
  • Asami Okamoto,
  • Yoshiyuki Miwa,
  • Kazuhiko Mori,
  • Yoshifumi Baba,
  • Yasuyuki Seto

摘要

Background

To evaluate the initial site of recurrence in patients with esophageal squamous cell carcinoma who underwent robot-assisted mediastinoscopic minimally invasive esophagectomy (RA-mMIE).

Methods

Patients who underwent RA-mMIE for thoracic esophageal squamous cell carcinoma between January 2012 and December 2023 were enrolled. The first site of recurrence was defined as the recurrent site classified into seven regions: inside the thoracic surgical field (ITSF), outside the thoracic surgical field (OTSF), inside the cervix (IC), supraclavicular (SC), inside the abdominal surgical field (IASF), outside the abdominal surgical field (OASF), and distant organs (DO).

Results

In total, 237 patients who underwent RA-mMIE were included in the analysis. Recurrence occurred in 66 (27.4%) patients. ITSF recurrence occurred in 22 (9.3%), OTSF in 22 (9.3%), IC in 3 (1.2%), SC in 11 (4.6%), IASF in 4 (1.7%), OASF in 8 (3.4%), and DO in 23 (9.7%). Solitary ITSF recurrence was observed in 1.0% (1/95), 4.2% (3/71), 8.9% (5/26), and 6.7% (1/15) of patients with cStages I, II, III, and IV, respectively. In cumulative incidence function analyses, cT and cN categories, clinical ITSF lymph node metastasis, pT category, radial margin positivity, and pathological ITSF lymph node metastasis were significantly associated with ITSF recurrence. In multivariate Fine–Gray proportional subdistribution hazard regression analyses, both cT (≥ 3) and pT (≥ 3) remained significant independent factors.

Conclusions

The ITSF recurrence rate after RA-mMIE was comparable to previously reported data, indicating that oncological radicality of RA-mMIE is sufficient in terms of local control capability.