Comparison of Short-term and Three-year Oncological Outcomes Between Robotic and Laparoscopic Gastrectomy for Gastric Cancer: A Large Multi-center Cohort Study.

OBJECTIVE

To compare the short- and long-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for gastric cancer.

SUMMARY BACKGROUND DATA

The clinical outcomes of RG over LG have not yet been effectively demonstrated.

METHODS

This retrospective cohort study included 3,599 patients with gastric cancer who underwent radical gastrectomy at eight high-volume hospitals in China from August 2016 to June 2019. Propensity score matching (PSM) was performed between patients who received RG and LG. The primary endpoint was 3-year disease-free survival (DFS).

RESULTS

After 1:1 PSM, 1034 pairs of patients were enrolled in a balanced cohort for further analysis. The 3-year DFS in the RG and LG was 83.7% and 83.1% (P=0.745), respectively, and the 3-year overall survival (OS) was 85.2% and 84.4%, respectively (P=0.647). During three years of follow-up, 154 patients in the RG and LG groups relapsed (cumulative incidence of recurrence: 15.0% vs. 15.0%, P=0.988). There was no significant difference in the recurrence sites between the two groups (all P>0.05). Sensitivity analysis showed that RG had comparable 3-year DFS (77.4% vs. 76.7%, P=0.745) and OS (79.7% vs. 78.4%, P=0.577) to LG in patients with advanced (pathological T2-4a) disease, and the recurrence pattern within three years was also similar between the two groups (all P>0.05). RG had less intraoperative blood loss, lower conversion rate, and shorter hospital stays than LG (all P>0.05).

CONCLUSIONS

For resectable gastric cancer, including advanced cases, RG is a safe approach with comparable 3-year oncological outcomes to LG when performed by experienced surgeons.

Informations de copyright

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Déclaration de conflit d'intérêts

Conflict of Interest Disclosures: None reported.