Comparison of robotic- and laparoscopic-assisted gastrectomy in advanced gastric cancer: updated short- and long-term results.


Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
02 2019
Historique:
received: 14 04 2018
accepted: 06 07 2018
pubmed: 18 7 2018
medline: 18 2 2020
entrez: 18 7 2018
Statut: ppublish

Résumé

Emerging evidence has demonstrated that either laparoscopic-assisted gastrectomy (LAG) or robotic-assisted gastrectomy (RAG) could be adopted as standard treatment for early gastric cancer. However, the long-term survival and recurrence rate after LAG or RAG for locally advanced gastric cancer (AGC) has seldom been reported. We retrospectively analyzed the data from 339 patients who underwent LAG and 163 patients who underwent RAG from a prospectively established database in the Chinese People's Liberation Army General Hospital. We compared the short- and long-term oncological outcomes of the RAG group versus the LAG group in the entire cohort, and in a propensity score-matched cohort. Before propensity score matching (PSM), the two groups revealed comparable 3-year overall survival rates (OS, RAG vs. LAG: 76.1 vs. 81.7%, p = 0.118), and recurrence-free survival rates (RFS, RAG vs. LAG: 73.0 vs. 67.6%, p = 0.297). Similar results were obtained in the propensity score-matched cohort; the respective overall survival rates in the propensity score-matched RAG and LAG groups were 76.1 and 79.8% (p = 0.552), and the respective RFS rates were 73.0 and 68.7% (p = 0.386). After PSM, RAG was still associated with a significantly longer mean operating time (249.46 ± 63.26 vs. 232.17 ± 65.39 min, p = 0.008) and higher total costs (133.38 ± 41.62 vs. 95.34 ± 29.39 10 Although there were some differences in the outcomes of RAG versus LAG in AGC patients, both RAG and LAG were similar in short-term recovery and long-term oncological outcomes.

Sections du résumé

BACKGROUND
Emerging evidence has demonstrated that either laparoscopic-assisted gastrectomy (LAG) or robotic-assisted gastrectomy (RAG) could be adopted as standard treatment for early gastric cancer. However, the long-term survival and recurrence rate after LAG or RAG for locally advanced gastric cancer (AGC) has seldom been reported.
METHODS
We retrospectively analyzed the data from 339 patients who underwent LAG and 163 patients who underwent RAG from a prospectively established database in the Chinese People's Liberation Army General Hospital. We compared the short- and long-term oncological outcomes of the RAG group versus the LAG group in the entire cohort, and in a propensity score-matched cohort.
RESULTS
Before propensity score matching (PSM), the two groups revealed comparable 3-year overall survival rates (OS, RAG vs. LAG: 76.1 vs. 81.7%, p = 0.118), and recurrence-free survival rates (RFS, RAG vs. LAG: 73.0 vs. 67.6%, p = 0.297). Similar results were obtained in the propensity score-matched cohort; the respective overall survival rates in the propensity score-matched RAG and LAG groups were 76.1 and 79.8% (p = 0.552), and the respective RFS rates were 73.0 and 68.7% (p = 0.386). After PSM, RAG was still associated with a significantly longer mean operating time (249.46 ± 63.26 vs. 232.17 ± 65.39 min, p = 0.008) and higher total costs (133.38 ± 41.62 vs. 95.34 ± 29.39 10
CONCLUSION
Although there were some differences in the outcomes of RAG versus LAG in AGC patients, both RAG and LAG were similar in short-term recovery and long-term oncological outcomes.

Identifiants

pubmed: 30014325
doi: 10.1007/s00464-018-6327-5
pii: 10.1007/s00464-018-6327-5
doi:

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

528-534

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Auteurs

Yunhe Gao (Y)

Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
General Surgery Institute, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.

Hongqing Xi (H)

Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
General Surgery Institute, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.

Zhi Qiao (Z)

Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.

Jiyang Li (J)

Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
General Surgery Institute, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.

Kecheng Zhang (K)

Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.
General Surgery Institute, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.

Tianyu Xie (T)

Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.

Weisong Shen (W)

Nanjing General Hospital of Nanjing Military Command, Nanjing, 210002, People's Republic of China.

Jianxin Cui (J)

Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China.

Bo Wei (B)

Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China. weibo@vip.163.com.
General Surgery Institute, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China. weibo@vip.163.com.

Lin Chen (L)

Department of General Surgery, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China. chenlinbj@sina.com.
General Surgery Institute, Chinese People's Liberation Army General Hospital, Fuxing Road 28, Beijing, 100853, People's Republic of China. chenlinbj@sina.com.

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