title: Safety and feasibility of thoracoscopic esophagectomy after neoadjuvant chemotherapy for esophageal cancer.
abstract: OBJECTIVE
  Neoadjuvant chemotherapy (NAC) with cisplatin and fluorouracil is the recommended standard treatment for resectable locally advanced esophageal cancer (EC) in Japan. We investigated the effects of NAC on the safety and feasibility of thoracoscopic esophagectomy with total mediastinal lymphadenectomy for EC.
  
  
  METHODS
  This retrospective study analyzed data from 225 consecutive patients who underwent thoracoscopic esophagectomy with lymph node dissection between April 2007 and December 2015. Patients with clinical stage IB, IIA, IIB, IIIA, or IIIB EC, and no active concomitant malignancy were included. We compared intraoperative outcomes, and postoperative morbidity and mortality between patients who received NAC (n = 139; NAC group) and patients who did not (n = 86; non-NAC group).
  
  
  RESULTS
  Preoperative laboratory data revealed that anemia, thrombopenia, and renal dysfunction were more common in the NAC group than in the non-NAC group. There were no differences between the groups in operating times, blood loss, number of dissected lymph nodes, overall complication rates, or length of postoperative hospital stay.
  
  
  CONCLUSIONS
  Based on our findings, thoracoscopic esophagectomy is safe and effective for locally advanced EC, even after NAC.
authors.affiliation: Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan. fujiwaray@msic.med.osaka-cu.ac.jp.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Fujiwara
authors.affiliation: Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kishida
authors.affiliation: Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Ryoya
authors.initials: R
authors.lastname: Hashiba
authors.affiliation: Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Gyobu
authors.affiliation: Department of Upper Gastrointestinal Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Takemura
authors.affiliation: Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Harushi
authors.initials: H
authors.lastname: Osugi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000628:therapy*; D016629:Esophagectomy; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012449:Safety; D013906:Thoracoscopy; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin; D005472:Fluorouracil
keywords: Esophageal carcinoma; Neoadjuvant chemotherapy; Thoracoscopic esophagectomy