New study tests if All-Keyhole surgery beats hybrid approach for esophageal cancer

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: Inclusion criteria for screening - part A (for patients receiving a neo-adjuvant treatment) * Age ≥ 18 years and ≤ 80 years For patients between 70 and 80 years old : score G8 ≥ 14 or oncogeratrician approval * Squamous cell carcinoma or adenocarcinoma of the esophagus or esogastric junction * Clinical stage T1, T2, T3, T4a, N0-N3, M0 before any treatment * Tumors of the middle or lower third of the esophagus, or tumor of the esogastric junction Siewert 1 or 2 * With or without neoadjuvant (radio) chemotherapy ± targeted therapy * Disease deemed curatively resectable preoperatively * Requiring a 2-stage Ivor-Lewis esophagectomy * Performance status 0, 1 or 2 * Patient capable of receiving either surgical treatment * Patient informed of the terms of the study and having given written consent * Patient able to read and understand the language and content of the study documents and agreeing to adhere to the protocol requirements. * Covered by a medical/health insurance * Willingness and ability to comply with scheduled visits and study procedures Inclusion criteria before surgery (after neo-adjuvant treatment or for patients receiving primary surgery) * Age ≥ 18 years and ≤ 80 years For patients between 70 and 80 years old : score G8 ≥ 14 or oncogeratrician approval * Squamous cell carcinoma or adenocarcinoma of the esophagus or esogastric junction * Clinical stage T1, T2, T3, N0-N3, M0 before surgery * Tumors of the middle or lower third of the esophagus, or tumor of the esogastric junction Siewert 1 or 2 * With or without neoadjuvant (radio) chemotherapy ± targeted therapy * Disease deemed curatively resectable preoperatively * Requiring a 2-stage Ivor-Lewis esophagectomy * Performance status 0, 1 or 2 * Patient capable of receiving either surgical treatment * Patient informed of the terms of the study and having given written consent * Patient able to read and understand the language and content of the study documents and agreeing to adhere to the protocol requirements. * Covered by a medical/health insurance * Willingness and ability to comply with scheduled visits and study procedures Exclusion Criteria: Non inclusion criteria for screening - part A (for patients receiving a neo-adjuvant treatment) Patient-related non-inclusion criteria * Performance status 3 or 4 * Documented liver cirrhosis or portal hypertension * Recent myocardial infarction (less than 6 months old) or progressive coronary artery disease * Distal arteritis from stage IIb (200 m) of Leriche and Fontaine * Synchronous cancer, other than subcarinal esophageal * Neoplasic history except for cancers without recurrence after at least 5 years of surveillance * History of xyphopubic laparotomy * Patients with prior thoracic surgery or thoracic traum of the right hemithorax * Patient refusal * Patient under guardianship or curatorship * Pregnant or breastfeeding woman or patient expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 6 months after the last dose of adjuvant chemotherapy * ASA score\> 3 Disease-related non-inclusion criteria * Histology other than squamous cell carcinoma or adenocarcinoma * Tumors of the upper third of the thoracic esophagus, cervical esophagus or pharyngo-esophageal junction or tumor of the esogastric junction Siewert 3 * Supraclavicular nodes invaded clinically or on puncture * Recurrent nerve paralysis * Evidence of extension to the tracheobronchial tree * Signs of mediastinal invasion (vertebral adhesion, aortic overlap \> 90°, invasion of unresectable neighboring organs such as the aorta, trachea…) * Distant metastatic extension Non inclusion criteria before surgery (after neo-adjuvant treatment or for patients receiving primary surgery) * Performance status 3 or 4 * Forced expiratory volume in 1 second \< 1000 ml * Documented liver cirrhosis or portal hypertension * Recent myocardial infarction (less than 6 months old) or progressive coronary artery disease * Distal arteritis from stage IIb (200 m) of Leriche and Fontaine * Weight loss of more than 15% of body weight, not recovered after appropriate nutritional management * Synchronous cancer, other than subcarinal esophageal * Neoplasic history except for cancers without recurrence after at least 5 years of surveillance * History of xyphopubic laparotomy * Patients with prior thoracic surgery or thoracic traum of the right hemithorax * Patient refusal * Patient under guardianship or curatorship * Pregnant or breastfeeding woman or patient expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 6 months after the last dose of adjuvant chemotherapy * ASA score\> 3 * IESG ≤ -5 (Very high risk patients) Disease-related non-inclusion criteria * Histology other than squamous cell carcinoma or adenocarcinoma * Tumors of the upper third of the thoracic esophagus, cervical esophagus or pharyngo-esophageal junction or tumor of the esogastric junction Siewert 3 * Supraclavicular nodes invaded clinically or on puncture * Recurrent nerve paralysis * Evidence of extension to the tracheobronchial tree * Signs of mediastinal invasion (vertebral adhesion, aortic overlap \> 90°, invasion of unresectable neighboring organs such as the aorta, trachea…) * Distant metastatic extension