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Japanese Society to Elevate Thoracoscopic Esophagectomy to Standard Treatment After Long-Term Study

Long-term results show the minimally invasive approach achieves survival equal to open surgery.

Overview

  • The National Cancer Center and Hamamatsu Medical University reported randomized trial findings and urged adopting thoracoscopic surgery as a standard option for esophageal cancer.
  • The Japanese Esophageal Society said it will update its clinical practice guidelines within the week, shifting thoracoscopic esophagectomy from a weak to a strong recommendation.
  • In 300 stage I–III patients, three-year overall survival was 82.0% with thoracoscopy versus 70.9% with open surgery, and disease-free survival was 72.9% versus 61.9%, meeting non-inferiority.
  • Rates of intraoperative injury, postoperative pneumonia, and anastomotic leakage showed no clear differences, and respiratory function decline at three years was significantly lower with the minimally invasive approach.
  • Researchers highlighted smaller scars, less postoperative pain, and better quality of life, and noted the findings were published in a Lancet family journal with procedures performed by credentialed or supervised surgeons.