Neoadjuvant chemoradiotherapy followed by active surveillance versus standard surgery for oesophageal cancer (SANO trial): a multicentre, stepped-wedge, cluster-randomised, non-inferiority, phase 3 trial

Xie D, Shen J, Liu L, Cao B, Xiao A, Qin J et al.

Br J Surg 2024; 111: znae106.

In this study that included 169 patients, the addition of complete mesogastric excision improved 3-year disease-free survival (85 versus 75.5 per cent, P=0.042), but not quite overall survival (85.8 versus 77.5 per cent, P=0.058).

Comment: It remains unknown whether this makes a big enough difference.

Chao Y-K, Li Z, Jiang H, Wen Y-W, Chiu C-H, Li B et al.

Br J Surg 2024; 111: znae143.

This study included 203 patients with tumour lymph nodes near the recurrent laryngeal nerve. Successful removal of lymph nodes adjacent to the nerve was more likely with robotic dissection (88.3 versus 69 per cent video-assisted, P<0.001). The rate of recurrent laryngeal nerve palsy after surgery was also reduced by robotic dissection: 20.4 versus 34 per cent, P=0.029.

Comment: Surgery was more accurate with the robot, with reduced recurrent laryngeal nerve damage.

Huang Z-N, Tang Y-H, Zhong Q, Li P, Xie J-W, Wang J-B et al.

Ann Surg 2024; 279: 923-931.

In this study that included 236 patients, the number of lymph nodes retrieved was significantly higher in the indocyanine green group: 48 versus 38, P<0.001.

Comment: Clinical outcomes awaited.