ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Minimally Invasive Esophagectomy Drives a Decade-Long Decline in Upper Mediastinal Recurrence After Esophageal Cancer Surgery: A Real-World, Single-Center Cohort Study
Provisionally accepted
- 1Shandong Provincial Hospital, Jinan, China
- 2Jining Medical University, Jining, China
- 3Jining No 1 People's Hospital, Jining, China
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Background: Surgery is a cornerstone in the treatment of esophageal cancer, yet high postoperative recurrence rates remain a significant challenge. This study aimed to retrospectively examine the trends in postoperative recurrence rates of esophageal cancer over the past decade and identify factors influencing these trends. Methods: Data from 918 esophageal cancer patients who underwent surgery at Jining First People's Hospital between January 2013 and May 2021 were analyzed. The follow-up period ranged from 32 to 98 months. Monthly recurrence rates were calculated to observe trends over time. Surgical techniques included various open and minimally invasive approaches. Follow-up assessments involved regular clinical evaluations and imaging studies. Statistical analyses were performed using SPSS, GraphPad Prism, and R software to identify factors influencing recurrence. Results: A total of 918 patients were included, with 224 experiencing local recurrence. The local recurrence rate showed a significant year-over-year decline (p = 0.000), primarily driven by a reduction in upper mediastinal lymph node recurrence (r = 0.4086, p = 0.0006). In contrast, distant recurrence rates did not exhibit a significant trend. Univariate and multivariate analyses identified several factors influencing upper mediastinal lymph node recurrence, including surgical method, alcohol consumption, number of lymph nodes dissected, and pTNM stage. Minimally invasive esophagectomy (MIE) was found to be an independent factor associated with a reduced monthly recurrence rate in the upper mediastinum (r = -0.3009, p = 0.0134). Conclusions: The study demonstrated a consistent decline in local recurrence rates over the past decade, particularly in upper mediastinal lymph nodes. The adoption of minimally invasive surgical techniques, improvements in perioperative management, and the evolving role of neoadjuvant therapy likely contributed to this trend.
Keywords: Minimally invasive, esophageal cancer, Recurrence, Lymph Nodes, Surgery, Neoadjuvant Therapy
Received: 23 Sep 2025; Accepted: 04 Nov 2025.
Copyright: © 2025 Zhang, Hu, Sun, Wei, Zhang, Zhong, Cai and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Gongchao Wang, wanggongchao@126.com
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