• Marianne C Kalff, Mark I van Berge Henegouwen, Peter C Baas, Renu R Bahadoer, BeltEric J TEJTDepartment of Surgery, Albert Schweitzer Ziekenhuis, Dordrecht, the Netherlands., Baukje Brattinga, Linda Claassen, Admira Ćosović, David Crull, Freek Daams, Annette D van Dalsen, DekkerJan Willem TJWTDepartment of Surgery, Reinier de Graaf Groep, Delft, the Netherlands., Marc J van Det, Manon Drost, Peter van Duijvendijk, Wietse J Eshuis, Stijn van Esser, Marcia P Gaspersz, Burak Görgec, GroenendijkRichard P RRPRDepartment of Surgery, IJsselland Ziekenhuis, Capelle aan de IJssel, the Netherlands., Henk H Hartgrink, Erwin van der Harst, Jan Willem Haveman, Joos Heisterkamp, Richard van Hillegersberg, Wendy Kelder, B Feike Kingma, Willem J Koemans, Ewout A Kouwenhoven, Sjoerd M Lagarde, Frederik Lecot, Philip P van der Linden, LuyerMisha D PMDPDepartment of Surgery, Catharina Ziekenhuis, Eindhoven, the Netherlands., NieuwenhuijzenGrard A PGAPDepartment of Surgery, Catharina Ziekenhuis, Eindhoven, the Netherlands., Pim B Olthof, Donald L van der Peet, PierieJean-Pierre E NJENDepartment of Surgery, MC Leeuwarden, Leeuwarden, the Netherlands., PierikE G J M RobertEGJMRDepartment of Surgery, Isala Klinieken, Zwolle, the Netherlands., Victor D Plat, Fatih Polat, Camiel Rosman, Jelle P Ruurda, Johanna W van Sandick, Rene Scheer, Cettela A M Slootmans, Meindert N Sosef, Odin V Sosef, Wobbe O de Steur, StockmannHein B A CHBACDepartment of Surgery, Spaarne Gasthuis, Haarlem, the Netherlands., Fanny J Stoop, Daan M Voeten, Guusje Vugts, Guy H E J Vijgen, Víola B Weeda, Marinus J Wiezer, van OijenMartijn G HMGHDepartment of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands., and Suzanne S Gisbertz.
• Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands.
• Ann. Surg. 2023 Apr 1; 277 (4): 619628619-628.

ObjectiveThis study evaluated the nationwide trends in care and accompanied postoperative outcomes for patients with distal esophageal and gastro-esophageal junction cancer.Summary Of Background DataThe introduction of transthoracic esophagectomy, minimally invasive surgery, and neo-adjuvant chemo(radio)therapy changed care for patients with esophageal cancer.MethodsPatients after elective transthoracic and transhiatal esophagectomy for distal esophageal or gastroesophageal junction carcinoma in the Netherlands between 2007-2016 were included. The primary aim was to evaluate trends in both care and postoperative outcomes for the included patients. Additionally, postoperative outcomes after transthoracic and tran-shiatal esophagectomy were compared, stratified by time periods.ResultsAmong 4712 patients included, 74% had distal esophageal tumors and 87% had adenocarcinomas. Between 2007 and 2016, the proportion of transthoracic esophagectomy increased from 41% to 81%, and neo-adjuvant treatment and minimally invasive esophagectomy increased from 31% to 96%, and from 7% to 80%, respectively. Over this 10-year period, postoperative outcomes improved: postoperative morbidity decreased from 66.6% to 61.8% ( P = 0.001), R0 resection rate increased from 90.0% to 96.5% (P <0.001), median lymph node harvest increased from 15 to 19 ( P <0.001), and median survival increased from 35 to 41 months ( P = 0.027).ConclusionIn this nationwide cohort, a transition towards more neo-adju-vant treatment, transthoracic esophagectomy and minimally invasive surgery was observed over a 10-year period, accompanied by decreased postoperative morbidity, improved surgical radicality and lymph node harvest, and improved survival.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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