MS O09 - OGC Long-term oncological outcomes following totally minimally invasive, hybrid and open oesophagectomy for cancer

Abstract Background There has been a significant shift in the surgical management of oesophageal cancer, with increased popularity of minimally invasive oesophagectomy in comparison to open approaches. Data thus far has largely focused on the peri-operative and short-term benefits with limited study on long-term oncological outcomes. This study aims to explore patterns of oesophageal cancer recurrence and survival following minimally invasive and open oesophagectomy. Method This was a retrospective review of consecutive patients who underwent open (OO), hybrid (HO) and minimally invasive (MIO) oesophagectomy for cancer at a regional oesophago-gastric centre in the UK between 2014-2023. Follow-up data was obtained from the centre’s established surgical database, in addition to the regional radiology, MDT and electronic patient records to record survival, recurrence, and patterns of recurrence (locoregional, haematological, distal nodal, peritoneal and number of recurrence sites). Results 437 patients (170 OO; 132 HO; 135 MIO) were included. There was no difference in baseline data between the groups. Overall survival rates at 1-, 3-, and 5-year were 88%, 64% and 54%. Recurrence rates at 1-, 3-, and 5-year were 17%, 35% and 41%. Haematological and locoregional recurrence made up 37% and 33% of all recurrence types. 52% of patients had one type of recurrence at diagnosis. After adjusting for disease stage, there was no significant difference between operative approaches with respect to survival and recurrence rates (at 1,3 and 5 years), time to recurrence, or patterns of recurrence. Conclusion This study found no significant difference in long-term oncological outcomes when comparing different minimally invasive and open surgical approaches to oesophagectomy. MIO can continue to be offered to patients as a safe alternative to open surgery. Further multi-centre prospective research is required to validate these results.