MIRO trial: 3-year outcomes favour laparoscopic surgery for oesophageal cancer

September 5, 2017, European Society for Medical Oncology

Patients requiring surgery for oesophageal cancer fare better after undergoing a hybrid minimally invasive oesophagectomy (HMIO) compared to an open oesophagectomy (OO), according to long-term results of the MIRO trial to be presented at the ESMO 2017 Congress in Madrid.

Mature results of the phase 3 study, with follow-up to a median of 48.8 months, demonstrate that the reduced surgical trauma associated with a , does not cut corners on safety, said investigator Dr.Guillaume Piessen, from University Hospital C. Huriez Place de Verdun in Lille, France.

"In addition to a 69 percent reduction in major intra- and postoperative morbidity, three-year overall survival was improved in the laparoscopic , showing that it is an oncologically sound procedure," he said.

While the survival difference between groups was not statistically significant, he called it "highly clinically relevant."

MIRO enrolled 207 adult patients from 13 centres with with resectable cancers of the middle or lower third of the oesophagus.

They were randomised to undergo either HMIO or an OO.

At 30-days, major postoperative morbidity occurred in significantly fewer patients in the HMIO compared to the OO group (35.9 percent versus 64.4 percent, odds ratio [OR] 0.31, 95 percentCI 0.18-0.55; p<0·001).

At three years, there was also a trend in the HMIO group towards improved overall survival and disease-free survival (67.0 percent versus 55 percent, p=0.05 and 57 percent versus 48 percent, p=0.15).

Commenting on the trial, Prof. Ulrich Güller, from Kantonsspital St. Gallen, Switzerland said:, "This represents an extremely important, well-designed and well-conducted study demonstrating that HMIO is an oncologically sound procedure and significantly reduces postoperative morbidity. Based on these results, the HMIO should become the new standard operating procedure for with mid and low oesophageal cancer."

Güller added, "I think it is key to mention Prof. Christophe Mariette, the first author of this important trial, who sadly passed away one month ago. Prof. Mariette was a model of a surgical scientist and an opinion leader in the field, and his contribution to the MIRO trial was of cardinal importance."

Explore further: IFCT-0302 results question role of CT-scan in non-small cell lung cancer post-surgery follow-up

More information: Abstract 615O_PR 'Hybrid Minimally Invasive vs. Open Esophagectomy for patients with Esophageal Cancer: Long-term outcomes of a multicentre, open-label, randomized phase III controlled trial, the MIRO trial" will be presented by Dr Guillaume Piessen during Proffered Paper Session 'Gastrointestinal tumours, non-colorectal 1' on Friday, 8 September 2017, 14:00 to 15:30 (CEST) in Barcelona Auditorium. cslide.ctimeetingtech.com/libr … 404/2017-09-08#2Bb5i

Related Stories

IFCT-0302 results question role of CT-scan in non-small cell lung cancer post-surgery follow-up

August 31, 2017
The optimal follow-up protocol for patients with completely resected non-small cell lung cancer (NSCLC) remains elusive after results of the IFCT-0302 trial, presented at the ESMO 2017 Congress in Madrid, did not show a difference ...

Laparoscopic surgery achieves similar survival rates in rectal cancer

April 2, 2015
(HealthDay)—Patients with localized rectal cancer may achieve similar survival rates by having minimally invasive laparoscopic surgery, instead of more invasive open surgery, according to new research published in the April ...

Findings support use of less invasive hysterectomy for early-stage endometrial cancer

March 28, 2017
Researchers found similar rates of disease-free survival and no difference in overall survival among women who received a laparoscopic or abdominal total hysterectomy for stage I endometrial cancer, according to a study published ...

Minimally invasive operation helps elderly patients after colon cancer treatment

October 8, 2013
The chance of ending up in a nursing facility appears to be significantly lower for older patients who undergo a laparoscopic procedure than for those who have open surgical resection for colon cancer, according to a study ...

Enhanced recovery pathway helpful in gyn-onc surgery

June 17, 2016
(HealthDay)—An enhanced recovery pathway is beneficial for gynecologic oncology patients undergoing minimally invasive surgery, according to a study published in the July issue of Obstetrics & Gynecology.

Survival similar with debulking by laparotomy, laparoscopy

April 10, 2017
(HealthDay)—For women with epithelial ovarian cancer, three-year survival rates are similar for women undergoing debulking by laparotomy or laparoscopy, according to a study published in the May issue of Obstetrics & Gynecology.

Recommended for you

Clues found to early lung transplant failure

May 21, 2018
Among organ transplant patients, those receiving new lungs face a higher rate of organ failure and death compared with people undergoing heart, kidney and liver transplants. One of the culprits is inflammation that damages ...

Blood type O patients may have higher risk of death from severe trauma

May 1, 2018
Blood type O is associated with high death rates in severe trauma patients, according to a study published in the open access journal Critical Care that involved 901 Japanese emergency care patients.

Brains, eyes, testes: off-limits for transplants?

April 28, 2018
Since the world's first successful organ transplant in 1954—a kidney—the discipline has advanced to the point where a wounded soldier could have his penis and scrotum replaced in a groundbreaking operation last month.

Emergency treatment by older surgeons linked to slightly lower death rates

April 26, 2018
Patients undergoing emergency surgery who are treated by older surgeons (aged 60 or over) have slightly lower death rates in the first few weeks after their operation than patients treated by younger surgeons (aged less than ...

Bionic suit helps paralyzed patients stand and walk again

April 25, 2018
Patients undergoing physical rehabilitation at Rush for paralyzing injuries are being aided by a robotic suit designed to help raise people to full height and walk.

Johns Hopkins performs first total penis and scrotum transplant in the world

April 23, 2018
Many soldiers returning from combat bear visible scars, or even lost limbs, caused by blasts from improvised explosive devices, or IEDs. However, some servicemen also return with debilitating hidden injuries—the loss of ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.