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SHORT OUTCOMES OF ROBOTIC TRANSHIATAL ESOPHAGECTOMY FOR ESOPHAGEAL ADENOCARCINOMA: A SINGLE INSTITUTION COMPARED TO THE NATIONAL CANCER DATABASE
Alona Bilik, Garnet Vanterpool, Iswanto Sucandy, Henry Zhang, Kristina Milivojev Covilo, Sharona B. Ross
*Digestive Health Institute, Advent Health Tampa, Tampa, FL
Introduction:
Esophageal adenocarcinoma (EAC) is a highly aggressive malignancy with poor survival rates, often presenting as advanced unresectable or metastatic disease. Surgical resection is the primary curative treatment, with robotic-assisted techniques showing improved postoperative outcomes, including shorter recovery times and hospital stays. However, limited studies compare robotic outcomes across institutions. This study evaluates robotic transhiatal esophagectomy (THE) outcomes at a single tertiary referral center, versus the National Cancer Database (NCDB).
Methods:
After IRB approval, a retrospective analysis was conducted on 78 EAC patients (our institution, 2013–2023) and 1,285 patients (NCDB, 2010–2020) undergoing robotic THE. Patients with incomplete data, non-total esophagectomies, or conversions to open operations were excluded. Propensity score matching (1:3) was completed based on age, sex, tumor grade, tumor size, AJCC staging, and Charlson Comorbidity Score yielded 39 at our institution and 125 NCDB patients. Outcomes were compared using median (mean±SD) values, with significance defined as p?0.05.
Results:
When comparing our institution’s outcomes against those presented in the NCDB, the median age of patients was 67 years for our institution and 68 years for NCDB. Females comprised 21% at our institution and 21% of the NCDB cohort. Neoadjuvant chemotherapy was administered [87% vs. 67%, p=0.0079] in comparison. Lymph nodes taken were less for our institution [11 (13±7.8) vs. 17 (18±9.6), p=0.0035]. However, when assessed for the learning curve our institution lymph node resections were [16 (16±8.14), 2017-2023, p=0.241]. Median hospital stay was [7 days vs. 9 days, p=0.04]. Thirty-day readmissions were [10% vs. 10%, p=0.98]. Mortality rates at 30 and 90 days were [3% vs. 2%, p=0.95; 5% vs. 8%, p=0.55, respectively].
Conclusion:
Robotic-assisted THE demonstrates comparable short-term outcomes to NCDB data, suggesting the feasibility of adopting robotic techniques in complex oncologic surgeries by experienced teams. Further studies are warranted to assess long-term survival outcomes.
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