Open Versus Laparoscopically-assisted Esophagectomy for Cancer

Inclusion Criteria: * Squamous cell or adenocarcinoma of the thoracic esophagus T1, T2, T3, N0-N1, M0, before any treatment * Middle or lower third esophageal carcinoma, junctional tumor Siewert type I * Patients who underwent or not neoadjuvant chemotherapy or chemoradiation * Tumor deemed to be resectable in a curative intent at the preoperative setting * Age less than 75 years old, OMS status 0, 1 or 2 * Patient who can undergo one or the other surgical modality * Written informed consent form * Possible follow-up Exclusion Criteria: 1. General criteria: PO2 ≤ 60 mmHg; PCO2 \> 45 mmHg; FEV ≤ 1000 ml/sec * Hepatic cirrhosis * Recent myocardial infarction (in the previous 6 months) or progressive coronary disease * Distal arteritis (Leriche-Fontaine stage II upwards) * Concomitant cancer, other than subcarinal esophageal cancer 2. Disease-related factors * Invasion of subclavicular lymph nodes in a clinical examination or on biospy * Lymph nodes near the origin of the celiac artery with a diameter ≥ 1 cm on CT or that appear to be suspect on endoscopic ultrasound (to differentiate them from the paracardial or left gastric lymph nodes, which does not constitute an exclusion criterion) * Recurrent nerve palsy * Evidence of extension to the tracheobronchial tree * Signs of mediastinal invasion (vertebral contact, aortic contact ≥ 90°, or invasion of nonresectable neighboring organs such as the aorta, trachea, main bronchi, etc.) * Distant metastasis 3. Laparoscopy-related factors * Patient presenting a general contraindication to laparoscopy * A history of median or subcostal laparotomy