On Apr. 9, 2025, Roswell Park Comprehensive Cancer Center achieved textbook outcomes for 90% of 150 consecutive robot-assisted, minimally invasive esophagectomies (RAMIE) performed between 2020-2024, as reported in a study in the Journal of Gastrointestinal Surgery.

The term “textbook outcomes” is used in the surgical field to refer to ideal outcomes, measured by such factors as the length of hospital stay and rate of complications, readmission to the hospital and mortality within 30 days after surgery. A recently published series documenting textbook outcomes from high-volume international centers reported a range of 40-45% — roughly half the percentage achieved at Roswell Park.

Esophagectomy — removal of the diseased portion of the esophagus — is a mainstay treatment for esophageal cancer. After removal of the cancerous part of the esophagus — the tube that carries food from the throat to the stomach — the stomach is lifted up into the chest from the abdomen so it can be reattached to the remaining part of the esophagus.

The surgery is associated with serious complications and a typical mortality rate of 3-5%, even at centers that perform a high number of procedures — a characteristic usually linked to better outcomes. But the Roswell Park team achieved 30-day and 90-day mortality rates of only 0.7% and 1.3%, respectively.

The Roswell Park team hopes the results of their study will encourage other centers to adopt these strategies, leading to a standardized approach to esophagectomy and better overall outcomes for more patients.