ASO Author Reflections: Safety and Feasibility of Robot-Assisted Minimally Invasive Esophagectomy (RAMIE) with Three-Field Lymphadenectomy and Neoadjuvant Chemoradiotherapy in Patients with Resectable Esophageal Cancer and Cervical Lymph Node Metastasis

Abstract

PASTEsophageal cancer remains a devastating disease, of which the incidence is increasing. 1 The cornerstone of treatment with curative intent is surgical resection.However, in case of preoperatively confirmed lymph node metastasis to the neck, patients are generally precluded surgery.The concurrent palliative treatment approach is associated with a limited 1 year survival of 32-39%.An alternative treatment approach would be neoadjuvant chemoradiotherapy followed by robot-assisted minimally invasive esophagectomy (RAMIE) with three-field lymphadenectomy, including the cervical lymph nodes.Whether this would be feasible and safe for the Western population was unclear up to now. PRESENTThis study shows that robot-assisted minimally invasive esophagectomy (RAMIE) with three-field lymphadenectomy is feasible in patients with resectable esophageal cancer presenting with cervical lymph node metastasis in a Western population. 2 Moreover, postoperative complications are comparable to those reported after curative treatment by high-volume centers and randomized trials.