{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:08:29Z","timestamp":1782860909283,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100013015","name":"Cedars-Sinai Medical Center","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013015","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Surgery remains the gold standard for non-metastatic esophageal cancer. Oncologic resection is considered adequate when 15 regional lymph nodes are sampled and specimen margins are negative. We hypothesize that racial and regional disparities exist in who receives an adequate oncologic resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The National Cancer Database (NCDB) was queried from 2010 to 2021 for patients who underwent esophagectomy for cancer. Exclusion criteria included stage IV disease and incomplete data. Adequate resection was defined as\u2009\u2265\u200915 lymph nodes removed and negative margins. A multivariable regression model identified factors associated with adequate resection, and survival was assessed using Kaplan\u2013Meier curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      11,451 patients were included. Of these, 5153 (45.0%) had an adequate oncologic resection. Black patients had increased odds of an inadequate resection compared to white patients (OR 1.490, 95%CI 1.227\u20131.809,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Patients treated at community or comprehensive cancer programs had higher odds of inadequate resection than those treated at academic programs. Medicaid patients had higher odds of an inadequate resection compared to those with private insurance (OR 1.397, 95%CI 1.172\u20131.664,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009= &lt;\u20090.01), while a minimally invasive esophagectomy (MIE) had 24.0% decreased odds of inadequate resection, and robotic-assisted esophagectomy (RAMIE) had 35.4% decreased odds compared to open surgery (95%CI 0.695\u20130.830,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01; 95%CI 0.567\u20130.735,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Controlling for stage, 5-year survival was higher for patients with an adequate resection. Resection adequacy improved from 38.5% in 2010 to 60.1% in 2021, with increases in MIE and RAMIE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Disparities persist in who receives adequate resection for esophageal cancer, though overall resection adequacy has improved, these findings should be interpreted in the context of evolving practice patterns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-12614-x","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T16:30:29Z","timestamp":1770654629000},"page":"3357-3367","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does robotic-assisted esophagectomy improve outcomes compared to other techniques? An NCDB analysis of access and disparities"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8581-8773","authenticated-orcid":false,"given":"Claire","family":"Perez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Krishna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Weiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen","family":"Razavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie","family":"Knabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevannah G.","family":"Soukiasian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Rocco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philicia","family":"Moonsamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harmik J.","family":"Soukiasian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Brownlee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"issue":"6","key":"12614_CR1","first-page":"394","volume":"68","author":"F Bray","year":"2018","unstructured":"Bray F, Ferlay J, Soerjomataram I et al (2018) Global cancer statistics 2018 GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer J Clin 68(6):394\u2013424","journal-title":"CA: A Cancer J Clin"},{"issue":"2","key":"12614_CR2","doi-asserted-by":"publisher","first-page":"194","DOI":"10.6004\/jnccn.2015.0028","volume":"13","author":"JA Ajani","year":"2015","unstructured":"Ajani JA, D\u2019Amico TA, Almhanna K et al (2015) Esophageal and esophagogastric junction cancers, version 1.2015. J Natl Compr Canc Netw 13(2):194\u2013227","journal-title":"J Natl Compr Canc Netw"},{"key":"12614_CR3","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000001369","author":"E Booka","year":"2015","unstructured":"Booka E, Takeuchi H, Nishi T, Matsuda S, Kaburagi T, Fukuda K, Nakamura R, Takahashi T, Wada N, Kawakubo H, Omori T (2015) The impact of postoperative complications on survivals after esophagectomy for esophageal cancer. Medicine. https:\/\/doi.org\/10.1097\/md.0000000000001369","journal-title":"Medicine"},{"issue":"2","key":"12614_CR4","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.athoracsur.2018.08.039","volume":"107","author":"F Espinoza-Mercado","year":"2019","unstructured":"Espinoza-Mercado F, Imai TA, Borgella JD, Sarkissian A, Serna-Gallegos D, Alban RF, Soukiasian HJ (2019) Does the approach matter? Comparing survival in robotic, minimally invasive, and open esophagectomies. Ann Thorac Surg 107(2):378\u201385","journal-title":"Ann Thorac Surg"},{"issue":"7","key":"12614_CR5","doi-asserted-by":"publisher","first-page":"doy110","DOI":"10.1093\/dote\/doy110","volume":"32","author":"HY Deng","year":"2019","unstructured":"Deng HY, Luo J, Li SX, Li G, Alai G, Wang Y, Liu LX, Lin YD (2019) Does robot-assisted minimally invasive esophagectomy really have the advantage of lymphadenectomy over video-assisted minimally invasive esophagectomy in treating esophageal squamous cell carcinoma? A propensity score-matched analysis based on short-term outcomes. Dis Esophagus 32(7):doy110","journal-title":"Dis Esophagus"},{"key":"12614_CR6","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.1245\/s10434-015-4544-x","volume":"22","author":"PC Van der Sluis","year":"2015","unstructured":"Van der Sluis PC, Ruurda JP, Verhage RJ, Van Der Horst S, Haverkamp L, Siersema PD, Borel Rinkes IH, Ten Kate FJ, Van Hillegersberg R (2015) Oncologic long-term results of robot-assisted minimally invasive thoraco-laparoscopic esophagectomy with two-field lymphadenectomy for esophageal cancer. Ann Surg Oncol 22:1350\u20131356","journal-title":"Ann Surg Oncol"},{"key":"12614_CR7","doi-asserted-by":"publisher","DOI":"10.1002\/ags3.12862","author":"R Kalayarasan","year":"2024","unstructured":"Kalayarasan R, Sai Krishna P (2024) Robotic esophagectomy with function\u2010preserving radical mediastinal lymphadenectomy for esophageal cancer. Ann Gastroenterol Surg. https:\/\/doi.org\/10.1002\/ags3.12862","journal-title":"Ann Gastroenterol Surg"},{"key":"12614_CR8","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1245\/s10434-008-0169-7","volume":"16","author":"AM Koenig","year":"2009","unstructured":"Koenig AM, Prenzel KL, Bogoevski D, Yekebas EF, Bubenheim M, Faithova L, Vashist YK, Gawad KA, Baldus SE, Pantel K, Schneider PM (2009) Strong impact of micrometastatic tumor cell load in patients with esophageal carcinoma. Ann Surg Oncol 16:454\u2013462","journal-title":"Ann Surg Oncol"},{"issue":"4","key":"12614_CR9","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1097\/01.sla.0000184211.75970.85","volume":"242","author":"HJ Stein","year":"2005","unstructured":"Stein HJ, Feith M, Bruecher BL, Naehrig J, Sarbia M, Siewert JR (2005) Early esophageal cancer: pattern of lymphatic spread and prognostic factors for long-term survival after surgical resection. Ann Surg 242(4):566\u2013575","journal-title":"Ann Surg"},{"issue":"1","key":"12614_CR10","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-53245-3","volume":"14","author":"O Khoma","year":"2024","unstructured":"Khoma O, Paredes SR, Park JS, Kennedy CW, Falk GL (2024) Extensive lymphadenectomy may improve survival in node negative oesophageal cancer. Sci Rep 14(1):2711","journal-title":"Sci Rep"},{"issue":"4","key":"12614_CR11","doi-asserted-by":"publisher","first-page":"393","DOI":"10.6004\/jnccn.2023.0019","volume":"21","author":"JA Ajani","year":"2023","unstructured":"Ajani JA, D\u2019Amico TA, Bentrem DJ, Cooke D, Corvera C, Das P, Enzinger PC, Enzler T, Farjah F, Gerdes H, Gibson M (2023) Esophageal and esophagogastric junction cancers, version 2.2023, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 21(4):393\u2013422","journal-title":"J Natl Compr Canc Netw"},{"issue":"Suppl 8","key":"12614_CR12","doi-asserted-by":"publisher","first-page":"S713","DOI":"10.21037\/jtd.2017.07.42","volume":"9","author":"ER Hagens","year":"2017","unstructured":"Hagens ER, van Berge Henegouwen MI, Cuesta MA, Gisbertz SS (2017) The extent of lymphadenectomy in esophageal resection for cancer should be standardized. J Thorac Dis 9(Suppl 8):S713","journal-title":"J Thorac Dis"},{"key":"12614_CR13","doi-asserted-by":"publisher","first-page":"4443","DOI":"10.1245\/s10434-020-08578-4","volume":"27","author":"CJ Schlick","year":"2020","unstructured":"Schlick CJ, Khorfan R, Odell DD, Merkow RP, Bentrem DJ (2020) Adequate lymphadenectomy as a quality measure in esophageal cancer: is there an association with treatment approach? Ann Surg Oncol 27:4443\u20134456","journal-title":"Ann Surg Oncol"},{"key":"12614_CR14","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1245\/s10434-019-08176-z","volume":"27","author":"CJ Schlick","year":"2020","unstructured":"Schlick CJ, Khorfan R, Odell DD, Merkow RP, Bentrem DJ (2020) Margin positivity in resectable esophageal cancer: are there modifiable risk factors? Ann Surg Oncol 27:1496\u20131507","journal-title":"Ann Surg Oncol"},{"issue":"3","key":"12614_CR15","first-page":"53","volume":"43","author":"E Kelley","year":"2005","unstructured":"Kelley E, Moy E, Stryer D, Burstin H, Clancy C (2005) The national healthcare quality and disparities reports an overview. Med Care 43(3):53","journal-title":"Med Care"},{"issue":"3","key":"12614_CR16","first-page":"1092","volume":"89","author":"JB Dimick","year":"2010","unstructured":"Dimick JB, Cowan JA Jr, Knittig S et al (2010) National trends in esophagectomy: use, outcomes, and disparities in surgical access. Ann Thorac Surg 89(3):1092\u20131098","journal-title":"Ann Thorac Surg"},{"issue":"12","key":"12614_CR17","doi-asserted-by":"publisher","first-page":"9355","DOI":"10.1007\/s00464-022-09210-0","volume":"36","author":"SF Haider","year":"2022","unstructured":"Haider SF, Ma S, Xia W, Wood KL, Matabele MM, Quinn PL, Merchant AM, Chokshi RJ (2022) Racial disparities in minimally invasive esophagectomy and gastrectomy for upper GI malignancies. Surg Endosc 36(12):9355\u20139363. https:\/\/doi.org\/10.1007\/s00464-022-09210-0","journal-title":"Surg Endosc"},{"key":"12614_CR18","doi-asserted-by":"publisher","first-page":"1722","DOI":"10.1001\/jamaoncol.2016.6905","volume":"3","author":"DJ Boffa","year":"2017","unstructured":"Boffa DJ, Rosen JE, Mallin K et al (2017) Using the national cancer database for outcomes research: a review. JAMA Oncol 3:1722","journal-title":"JAMA Oncol"},{"issue":"4","key":"12614_CR19","doi-asserted-by":"publisher","first-page":"1536","DOI":"10.1016\/j.jtcvs.2021.05.048","volume":"163","author":"DC Patel","year":"2022","unstructured":"Patel DC, Yang CFJ, He H et al (2022) Influence of facility volume on long-term survival of patients undergoing esophagectomy for esophageal cancer. J Thorac Cardiovasc Surg 163(4):1536-1546.e3. https:\/\/doi.org\/10.1016\/j.jtcvs.2021.05.048","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"6","key":"12614_CR20","doi-asserted-by":"publisher","first-page":"doab083","DOI":"10.1093\/dote\/doab083","volume":"35","author":"IC Okereke","year":"2022","unstructured":"Okereke IC, Westra J, Tyler D, Klimberg S, Jupiter D, Venkatesan R, Brooks K, Kuo YF (2022) Disparities in esophageal cancer care based on race: a national cancer database analysis. Dis Esophagus 35(6):doab083","journal-title":"Dis Esophagus"},{"issue":"3","key":"12614_CR21","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1007\/s11605-020-04653-z","volume":"25","author":"SL Savitch","year":"2021","unstructured":"Savitch SL, Grenda TR, Scott W, Cowan SW, Posey J III, Mitchell EP, Cohen SJ, Yeo CJ, Evans NR III (2021) Racial disparities in rates of surgery for esophageal cancer: a study from the National Cancer Database. J Gastrointest Surg 25(3):581\u2013592","journal-title":"J Gastrointest Surg"},{"key":"12614_CR22","doi-asserted-by":"publisher","first-page":"2880","DOI":"10.1007\/s10620-018-5238-6","volume":"63","author":"AC Tramontano","year":"2018","unstructured":"Tramontano AC, Nipp R, Mercaldo ND, Kong CY, Schrag D, Hur C (2018) Survival disparities by race and ethnicity in early esophageal cancer. Dig Dis Sci 63:2880\u20132888","journal-title":"Dig Dis Sci"},{"issue":"10","key":"12614_CR23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0186350","volume":"12","author":"HH Thein","year":"2017","unstructured":"Thein HH, Anyiwe K, Jembere N, Yu B, De P, Earle CC (2017) Effects of socioeconomic status on esophageal adenocarcinoma stage at diagnosis, receipt of treatment, and survival: a population-based cohort study. PLoS ONE 12(10):e0186350","journal-title":"PLoS ONE"},{"key":"12614_CR24","doi-asserted-by":"publisher","DOI":"10.4103\/jcar.JCar_4_17","author":"PN Tran","year":"2017","unstructured":"Tran PN, Taylor TH, Klempner SJ, Zell JA (2017) The impact of gender, race, socioeconomic status, and treatment on outcomes in esophageal cancer: a population-based analysis. J Carcinog. https:\/\/doi.org\/10.4103\/jcar.JCar_4_17","journal-title":"J Carcinog"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-12614-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-12614-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-12614-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:38:49Z","timestamp":1782859129000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-026-12614-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["12614"],"URL":"https:\/\/doi.org\/10.1007\/s00464-026-12614-x","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]},"assertion":[{"value":"3 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Claire Perez, Vikram Krishna, Lucas Weiser, Allen Razavi, Kellie Knabe, Sevannah G. Soukiasian, Raffaele Rocco, Philicia Moonsamy, Harmik J. Soukiasian, and Andrew R. Brownlee do not have any disclosures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}