P1.157. International Comparison of Clinicopathologic Characteristics and Outcomes After Minimally Invasive transCervical Esophagectomy (MICE): A Retrospective Cohort Study

Abstract

Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer Background Minimally Invasive transCervical Esophagectomy (MICE) avoids a thoracic approach via transcervical mediastinal and abdominal dissection. Preserving pleural integrity may reduce pulmonary complications and allow for radical upper mediastinal dissection, but increases risk of (temporary) recurrent laryngeal nerve (RLN) injury. Comparing populations can clarify indications and support broader implementation in Europe. Methods This retrospective international cohort study includes patients (≥18 years) who underwent MICE for histologically confirmed esophageal carcinoma between 2021-2025 in a high volume center in Japan and in the Netherlands. The estimated sample size is approximately 150 patients per cohort. Data are collected from institutional databases and medical records in accordance with applicable laws, regulations and ethical guidelines. Clinicopathological variables, perioperative characteristics, and postoperative outcomes are collected. The primary endpoint of this study is postoperative pneumonia within 30 days. Secondary endpoints include anastomotic leakage (AL), recurrent laryngeal nerve (RLN) injury, mortality, lymph node yield, R0 resection rate and length of hospital stay. Categorial variables will be compared using chi-square of Fisher’s exact tests and continuous variables using t-test or Mann-Whitney U test. Multivariable logistic regression will adjust for potential confounders. Results Data transfer and harmonization of the Japanese and Dutch dataset are currently ongoing, and data analysis will commence shortly. Baseline clinicopathologic characteristics, including age, sex, comorbidities, histological subtype, tumor stage, and (neo)adjuvant treatment strategies, will be described for the overall population and compared between cohorts. Comparative analysis of postoperative outcomes, including pneumonia, AL, RLN injury, mortality, lymph node yield, R0 resection rate, and length of stay will be performed. Multivariable regression models will evaluate associations between geographic cohort, clinicopathological factors, treatment strategies and postoperative outcomes. Given established differences in tumor histology and multimodal treatment approaches between Eastern and Western populations, clinicopathologic differences are anticipated. Potential differences in postoperative complications between groups will be assessed. Final adjusted comparative results according to the predefined analysis plan will be presented at the congress. Conclusion This international study is the first to compare MICE outcomes between Japanese and Dutch cohorts. By comparing demographic and clinicopathological characteristics, treatment strategies and postoperative complications, this study will identify population differences in surgical risk and oncologic outcomes. Insights from these comparisons may inform treatment indications and support broader implementation of MICE in Europe, while providing insightful evidence on safety and efficacy, and highlight the value of international collaboration for future research.