TY - JOUR
T1 - Three-year outcomes of robotic gastrectomy versus laparoscopic gastrectomy for the treatment of clinical stage I/II gastric cancer
T2 - a multi-institutional retrospective comparative study
AU - Suda, Koichi
AU - Sakai, Miyoshi
AU - Obama, Kazutaka
AU - Yoda, Yukie
AU - Shibasaki, Susumu
AU - Tanaka, Tsuyoshi
AU - Nakauchi, Masaya
AU - Hisamori, Shigeo
AU - Nishigori, Tatsuto
AU - Igarashi, Ataru
AU - Noshiro, Hirokazu
AU - Terashima, Masanori
AU - Uyama, Ichiro
N1 - Funding Information:
Administrative support for this study, provided by EP-CRSU Co., Ltd, was funded by Intuitive Surgical Sarl. The funder was not involved in the study design; the collection, analysis, and interpretation of data; the writing of this article; or the decision to submit the article for publication.
Funding Information:
Koichi Suda was funded by Sysmex, Co. in relation to the Collaborative Laboratory for Research and Development in Advanced Surgical Intelligence, Fujita Health University. Koichi Suda also received advisory fees from Medicaroid, Inc., outside of the present study. Tsuyoshi Tanaka and Ichiro Uyama were funded by Medicaroid, Inc. in relation to the Collaborative Laboratory for Research and Development in Advanced Surgical Technology, Fujita Health University. Ichiro Uyama received lecture fees from Intuitive Surgical, Inc., outside of the present study. Kazutaka Obama received lecture fees from Intuitive Surgical, Inc., Medtronic, Ethicon, Medicaroid, Inc., and Olympus, outside of the present study. Ataru Igarashi received research expenses from Intuitive Surgical, Inc., outside of the present study. Masanori Terashima received personal fees from Taiho Pharmaceutical, Chugai Pharmaceutical, Ono Pharmaceutical, BMS, Yakult Honsha, Takeda Pharmaceutical, Eli Lilly Japan, Pfizer Japan, Daiichi-Sankyo, Johnson and Johnson, Medtronic Japan, Intuitive Surgical Japan, and Olympus, outside the submitted work. Miyoshi Sakai, Yukie Yoda, Susumu Shibasaki, Masaya Nakauchi, Shigeo Hisamori, Tatsuto Nishigori, and Hirokazu Noshiro have no conflicts of interest or financial ties to disclose. Koichi Suda, Kazutaka Obama, Tsuyoshi Tanaka, Ataru Igarashi, Masanori Terashima, and Ichiro Uyama have no conflicts of interest or financial ties to disclose in relation to the present study.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022
Y1 - 2022
N2 - Background: Oncological benefits of robotic gastrectomy (RG) remain unclear. We aimed to determine and compare the 3-year outcomes of RG and laparoscopic gastrectomy (LG) for the treatment of gastric cancer. Methods: This was a multi-institutional retrospective study of patients who prospectively underwent RG in a previous study (UMIN000015388) and historical controls who underwent LG. Operable patients with cStage I/II primary gastric cancer were enrolled. The inverse probability of treatment weighting method based on propensity scores was used to balance patient demographic factors and surgeon volume between the RG and LG groups. The primary outcome measure was the 3-year overall survival rate (3yOS). Results: Of the 1,127 patients in the previous study, 326 and 752 patients in the RG and LG groups, respectively, completed the study. The standardized difference of all confounding factors was reduced to 0.09 or less after weighting. In the weighted population, 3yOS was 96.3% and 89.6% in the RG and LG groups, respectively (hazard ratio [HR] 0.34 [0.15, 0.76]; p = 0.009), whereas there was no difference in 3-year recurrence-free survival rate (3yRFS) between the two groups (HR 0.58 [0.32, 1.05]; p = 0.073). Sub-analyses showed that RG improved 3yOS (HR 0.05 [0.01, 0.38]; p = 0.004) and 3yRFS (HR 0.05 [0.01, 0.34]; p = 0.003) in patients with pStage IA disease. Recurrence rates and patterns were similar between the RG and LG groups. RG did not improve the morbidity rate, however, it attenuated some of the adverse events, including anastomotic leakage and intra-abdominal abscess. RG improved estimated blood loss and duration of postoperative hospitalization. Conclusion: This study showed surgical and oncological safety of RG for cStage I/II gastric cancer considering the 3-year outcomes, compared with those of LG. Graphical abstract: [Figure not available: see fulltext.].
AB - Background: Oncological benefits of robotic gastrectomy (RG) remain unclear. We aimed to determine and compare the 3-year outcomes of RG and laparoscopic gastrectomy (LG) for the treatment of gastric cancer. Methods: This was a multi-institutional retrospective study of patients who prospectively underwent RG in a previous study (UMIN000015388) and historical controls who underwent LG. Operable patients with cStage I/II primary gastric cancer were enrolled. The inverse probability of treatment weighting method based on propensity scores was used to balance patient demographic factors and surgeon volume between the RG and LG groups. The primary outcome measure was the 3-year overall survival rate (3yOS). Results: Of the 1,127 patients in the previous study, 326 and 752 patients in the RG and LG groups, respectively, completed the study. The standardized difference of all confounding factors was reduced to 0.09 or less after weighting. In the weighted population, 3yOS was 96.3% and 89.6% in the RG and LG groups, respectively (hazard ratio [HR] 0.34 [0.15, 0.76]; p = 0.009), whereas there was no difference in 3-year recurrence-free survival rate (3yRFS) between the two groups (HR 0.58 [0.32, 1.05]; p = 0.073). Sub-analyses showed that RG improved 3yOS (HR 0.05 [0.01, 0.38]; p = 0.004) and 3yRFS (HR 0.05 [0.01, 0.34]; p = 0.003) in patients with pStage IA disease. Recurrence rates and patterns were similar between the RG and LG groups. RG did not improve the morbidity rate, however, it attenuated some of the adverse events, including anastomotic leakage and intra-abdominal abscess. RG improved estimated blood loss and duration of postoperative hospitalization. Conclusion: This study showed surgical and oncological safety of RG for cStage I/II gastric cancer considering the 3-year outcomes, compared with those of LG. Graphical abstract: [Figure not available: see fulltext.].
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U2 - 10.1007/s00464-022-09802-w
DO - 10.1007/s00464-022-09802-w
M3 - Article
AN - SCOPUS:85143547686
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
ER -