| アブストラクト | PURPOSE: This nationwide observational study investigated the recent trends and demographic patterns of esophageal cancer incidence and surgery in Japan. METHODS: The annual incidence data (2016-2021) and surgical procedure counts (2014-2023) were extracted from the Cancer Information Database and National Database of Health Insurance Claims and Specific Health Checkups. Surgeries were categorized by anatomical extent and surgical approach (open/thoracoscopic/mediastinoscopic), with minimally invasive procedures further categorized by robotic assistance. The crude and age-adjusted rates per 100,000 person-years were calculated. The temporal trends were evaluated using linear and Poisson regression models. RESULTS: The average annual incidence of esophageal cancer was 25,711 cases, and 5,896 surgeries were performed. While the cancer incidence remained stable, the surgical approaches have transformed significantly. A sharp decline was observed in traditional open surgeries (P < 0.0001), while the number of minimally invasive surgeries increased substantially. This included significant growth in thoracoscopic (P < 0.0001), mediastinoscopy (P = 0.0085), and robotic-assisted procedures (P = 0.0006), with annual risk ratios of 1.088, 1.185, and 1.440, respectively (all P < 0.0001). This transition toward minimally invasive techniques was the most pronounced among older adults. CONCLUSION: Esophageal cancer surgery in Japan is undergoing a major shift toward minimally invasive approaches, particularly in older patients. |
| 組織名 | Department of Orthopedic Surgery, Inage Hospital, 6-21-3 Konakadai, Inage-ku,;Chiba, 2630043, Japan.;First Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110;Shimokato, Yamanashi, 4093898, Chuo, Japan. kshoda@yamanashi.ac.jp.;Department of Mathematics and Statistics in Medical Sciences, Kyoto Prefectural;University of Medicine, 1-5 Shimogamo Hangi-cho, Sakyo-ku, Kyoto, 6060823, Japan.;Department of Molecular Gastroenterology and Hepatology, Graduate School of;Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho,;Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 6028566, Japan.;Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University;of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 6028566,;Japan.;Shimokato, Yamanashi, 4093898, Chuo, Japan. |