Thoracoscopic esophagectomy is related to better outcomes in early adenocarcinoma of esophagogastric junction tumors

Table 1 Epidemiological characteristics of the total number of patients with adenocarcinoma of the esophagogastric junction by type of operation

Characteristics		Group		Total	P value
		Thoracoscopygroup A	Transhiatalgroup B
		n = 54, n (%)	n = 93, n (%)	n = 147, n (%)
Gender	Female	6 (11.1)	11 (11.8)	17 (11.6)	0.8961
	Male	48 (88.9)	82 (88.2)	130 (88.4)
Age (yr)	mean ± SD	61.11 ± 9.03	65.72 ± 10.73	64.03 ± 10.35	0.0092
	Mean (vmin-vmax)	62.50 (37-84)	65.00 (36-94)	64.00 (36-94)
BMI class	BMI < 25 kg/m2	46 (85.2)	78 (83.9)	124 (84.4)	0.8331
	BMI > 25 kg/m2	8 (14.8)	15 (16.1)	23 (15.6)
Pre-surgical ECOG§	Score 0	50 (92.6)	79 (84.9)	129 (87.8)	0.1731
	Score 1	4 (7.4)	14 (15.1)	18 (12.2)
Diabetes	No	39 (72.2)	67 (72.0)	106 (72.1)	0.9811
	Yes	15 (27.8)	26 (28.0)	41 (27.9)
Cardiovascular diseases	No	21 (38.9)	34 (36.6)	55 (37.4)	0.7781
	Yes	33 (61.1)	59 (63.4)	92 (62.6)

¹Pearson’s chi-square test.

²Student’s t-test.

§ Score 0: Totally active and restricted activities; and Score 1: Restricted physical activities, but walking e apt to perform light work activities. vmin: Minimum value; vmax: Maximum value.

Table 2 Postoperative complications and mortality rates of the total number of patients with adenocarcinoma of the esophagogastric junction and by type of esophagectomy

		Group		Total	P value
		Thoracoscopygroup A	Transhiatalgroup B
		n = 54, n (%)	n = 93, n (%)	n = 147 , n (%)
Complications	No	27 (50.0)	60 (64.5)	87 (59.2)	0.0841
	Yes	27 (50.0)	33 (35.5)	60 (40.8)
Fistulae	No	48 (88.9)	80 (86.0)	128 (87.1)	0.6171
	Yes	6 (11.1)	13 (14.0)	19 (12.9)
Chylothorax	No	53 (98.1)	93 (100)	146 (99.3)	0.3672
	Yes	1 (1.9)	0	1 (0.7)
Respiratory disorders	No	46 (85.2)	85 (91.4)	131 (89.1)	0.2441
	Yes	8 (14.8)	8 (8.6)	16 (10.9)
Hoarseness	No	50 (92.6)	93 (100)	143 (97.3)	0.0172
	Yes	4 (7.4)	0	4 (2.7)
Infections	No	50 (92.6)	91 (97.9)	143 (97.3)	0.0172
	Yes	4 (7.4)	2 (2.1)	4 (2.7)
Mortality		2 (3.7)	4 (4.3)	6 (4.08%)	0.3422

¹Chi-square test.

²Fisher exact test.

Table 3 Number and characteristics of resected lymph nodes of patients with adenocarcinoma of the esophagogastric junction submitted to surgical treatment by transthoracic and transhiatal transthoracic esophagectomy

		Group		Total	P value
		Thoracoscopygroup A	Transhiatalgroup B
		n = 54, n (%)	n = 93, n (%)	n = 147, n (%)
Dissected lymph nodes	mean ± SD	31.89 ± 17.65	20.73 ± 12.70	24.83 ± 15.62	< 0.0011
Metastatic lymph nodes	Median (vmin-vmax)	30 (3-73)	19 (2-85)	22 (2-85)
	Median (vmin-vmax)	2 (0-25)	1 (0-34)	1 (0-34)
AL/DL (%)	mean ± SD	15.59 (21.44)	20.56 (28.12)	18.73 (25.90)	0.6961
	Median (vmin-vmax)	5.86 (0-92.31)	5.88 (0-97.14)	5.88 (0-97.14)

¹Mann-Whitney test. vmin: Minimum; vmax: Maximum; AL/DL: Affected lymph nodes/dissected lymph nodes.

Table 4 Univariate and multivariate analysis for disease-free survival and overall survival

Disease-free survival	Univariate analysis			Multivariate analysis
Variables	HR	95%CI	P value	HR	95%CI	P value
Male (vs female)	0.99	0.47–2.08	0.975
Age (< 62 yr vs > 62 yr)	0.87	0.56–3.14	0.873
Siewert 1 vs 2	1.11	0.14–8.89	0.921
TH vs TT (1, 2A)	1.71	1.01–2.90	0.046	1.73	1.00–2.99	0.049
Post-operative complications	1.22	0.56-2.06	0.961
G3 (vs G1/G2)	1.14	0.61–2.13	0.690
LN+/LN-	2.61	1.71-3.56	0.001	1.77	0.99-3.24	0.101
pT3/pT4 status (vs pT0/T1/pT2)	2.21	1.86–7.31	0.003	1.56	0.97-3.89	0.102
pN+ (vs pN0)	2.54	1.57-5.78	0.05	1.43	0.88-3.32	0.103
Pathological exam
Lymphatic	0.78	0.39-1.29	0.783
Venous	1.67	0.35-2.72	0.246
Neural	0.78	0.67-1.89	0.183
Overall survival	Univariate analysis		Multivariate analysis
Variables	HR	95%CI	P value	HR	95%CI	P value
Age (< 62 yr vs > 62 yr)	0.98	0.89-5.13	0.821
Siewert 1 vs 2	1.31	0.16-10.68	0.799
TH vs TT (1, 2A)	2.01	1.19-3.39	0.009	1.79	1.03-3.09	0.038
Post-operative complications	1.03	0.60-1.74	0.927
G3 (vs G1/G2)	2.37	1.36-4.16	0.003	2.54	1.33-4.82	0.005
LN+/LN-	1.72	1.00-3.48	0.050	1.21	0.87-3.46	0.732
pT3/pT4 status (vs pT0/T1/pT2)	5.95	1.81-19.61	0.003	9.96	2.43-40.74	0.001
pN+ (vs pN0)	1.68	1.38-3.90	0.002	1.18	0.86-4.99	0.735
Pathological exam
Lymphatic	0.47	0.23-1.78	0.109
Venous	0.49	0.20-1.06	0.076
Neural	1.80	0.96-3.35	0.065