Propensity Score-Matched Analysis of the Short- and Long-Term Outcomes of Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer

• Published in: Annals of surgical oncology Vol. 29; no. 6; pp. 3887 - 3895
• Main Authors: Nishi, Masaaki, Shimada, Mistuo, Yoshikawa, Kozo, Takasu, Chie, Wada, Yuma, Tokunaga, Takuya, Nakao, Toshihiro, Kashihara, Hideya, Yoshimoto, Toshiaki, Yamashita, Shoko
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.06.2022; Springer Nature B.V
• Subjects: Body mass index; Gastrectomy; Gastric cancer; Gastrointestinal Oncology; Gastrointestinal surgery; Laparoscopy; Lymph nodes; Medicine; Medicine & Public Health; Morbidity; Oncology; Patients; Robotic surgery; Surgery; Surgical Oncology; Survival; Tumor markers; Tumors
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-021-11203-7

Background Robotic gastrectomy (RG) has been rapidly adopted for gastric cancer (GC) treatment. However, the benefits of RG over laparoscopic gastrectomy (LG) for GC remain unclear. Methods A total of 451 patients who underwent either RG ( n = 83) or LG ( n = 368) for GC were enrolled in this study. A 1:1 matched, propensity score-matched analysis was performed using the following factors: age, sex, body mass index, pT, pN, pStage, tumor location, vessel invasion, tumor markers, surgical procedure, reconstruction method, extent of lymphadenectomy, and Endoscopic Surgical Skill Qualification System qualified surgeon as an operator. The surgical outcomes of the two groups were compared. Results A well-balanced cohort of 158 patients was analyzed ( n = 79 in the RG group, n = 79 in the LG group). Regarding the short-term outcomes, the respective blood loss volume, drain amylase content, and number of retrieved lymph nodes in the RG and LG groups were 38.62 ± 73.06 ml and 67.53 ± 108.20 ml ( p < 0.05), 450 ± 371 IU/l and 1590 ± 6392 IU/l ( p < 0.01), and 35.02 ± 15.51 and 25.28 ± 11.70 ( p < 0.01). The morbidity rate was similar between the RG and LG groups (not significant [NS]). Regarding the long-term survival outcomes, there were no intergroup differences in 3-year overall survival (91.72% in the RG group vs. 83.39% in the LG group: NS) and 3-year, disease-free survival (93.31% in the vs. 90.44%: NS). Conclusions RG was safe and contributed to better short-term outcomes and similar long-term survival outcomes compared with LG.