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Background <p>This study aimed to compare the long-term oncologic outcomes of NIRF-guided mediastinal lymphadenectomy during esophagectomy with those of conventional surgery.</p> Methods <p>The study enrolled consecutive patients who underwent esophagectomy for esophageal cancer by a single surgical team between September 2017 and July 2021. Patients treated after September 2019 received NIRF-guided mediastinal lymphadenectomy (NIRF group) and were compared with the earlier cohort (historical control group). Propensity-matching analysis was used to compare 3-year overall survival (OS), disease-free survival (DFS), and recurrence patterns between the groups. Survival outcomes were analyzed using Kaplan-Meier curves and Cox regression analysis.</p> Results <p>The final analysis included 118 matched patients (NIRF group, 59; historical control group, 59). The median follow-up period for all the patients was 38 months (range, 33–42 months). The NIRF group showed a significantly higher number of total lymph nodes (<i>P</i> = 0.010) and mediastinal lymph nodes (<i>P</i> = 0.045) dissected than the historical control group. The 1- and 3-year DFS rates were 68.1% and 45.2% for the NIRF group versus 74.3% and 55.2% for the historical control group. The OS rates for the NIRF group were 90.6% (1-year rate) and 72.0% (3-year rate) versus 98.3% (1-year rate) and 76.9% (3-year rate) for the historical control group. Both OS and DFS were comparable between the two groups (<i>P</i> = 0.271 and <i>P</i> = 0.356, log-rank test, respectively). Additionally, the two groups had similar recurrence patterns (<i>P</i> = 0.053).</p> Conclusion <p>The use of NIRF imaging during esophagectomy facilitates precise resection of mediastinal lymph nodes. However, its impact on patient survival remains limited.</p>

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Comparative Analysis of Long-Term Outcomes Between Near-Infrared Fluorescence Imaging with Indocyanine Green-Guided Mediastinal Lymphadenectomy and Conventional Surgery for Esophageal Cancer

  • 期刊论文

  • 发表日期：

    2025年5月3日

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  • Yong Ao,
  • Xiayu Fu,
  • Kongjia Luo,
  • Lu Shao,
  • Junying Chen,
  • Leqi Zhong,
  • Xin Zhang,
  • Shining Li,
  • Xiaodan Lin,
  • Changsen Leng,
  • Jianhua Fu,
  • Yi Hu

摘要

Background

This study aimed to compare the long-term oncologic outcomes of NIRF-guided mediastinal lymphadenectomy during esophagectomy with those of conventional surgery.

Methods

The study enrolled consecutive patients who underwent esophagectomy for esophageal cancer by a single surgical team between September 2017 and July 2021. Patients treated after September 2019 received NIRF-guided mediastinal lymphadenectomy (NIRF group) and were compared with the earlier cohort (historical control group). Propensity-matching analysis was used to compare 3-year overall survival (OS), disease-free survival (DFS), and recurrence patterns between the groups. Survival outcomes were analyzed using Kaplan-Meier curves and Cox regression analysis.

Results

The final analysis included 118 matched patients (NIRF group, 59; historical control group, 59). The median follow-up period for all the patients was 38 months (range, 33–42 months). The NIRF group showed a significantly higher number of total lymph nodes (P = 0.010) and mediastinal lymph nodes (P = 0.045) dissected than the historical control group. The 1- and 3-year DFS rates were 68.1% and 45.2% for the NIRF group versus 74.3% and 55.2% for the historical control group. The OS rates for the NIRF group were 90.6% (1-year rate) and 72.0% (3-year rate) versus 98.3% (1-year rate) and 76.9% (3-year rate) for the historical control group. Both OS and DFS were comparable between the two groups (P = 0.271 and P = 0.356, log-rank test, respectively). Additionally, the two groups had similar recurrence patterns (P = 0.053).

Conclusion

The use of NIRF imaging during esophagectomy facilitates precise resection of mediastinal lymph nodes. However, its impact on patient survival remains limited.