Comparison of short- and long-term outcomes of robotic vs. laparoscopic gastrectomy for clinical serosa-invasive gastric cancer: A multicenter cohort study.

IF 6.7 2区 医学 Q1 ONCOLOGY
Hualong Zheng, Zhiwei Zheng, Honghong Zheng, Taiyuan Li, Linghua Wei, Li Zhang, Junjun She, Baoqing Jia, Xingan Qin, Shuangyi Ren, Hongliang Yao, Zhen Xue, Lingkang Zhang, Jiabin Wang, Changming Huang, Ping Li
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引用次数: 0

Abstract

Objective: Robotic gastrectomy (RG) is increasingly used in the treatment of gastric cancer. However, studies on patients with clinical serosa-invasive (cT4a) gastric cancer remain scarce. This study aimed to compare the short- and long-term outcomes of RG and laparoscopic gastrectomy (LG) in the treatment of stage cT4a gastric cancer.

Methods: A retrospective analysis was conducted on the clinical data of patients with stage cT4a gastric cancer diagnosed and treated at eight high-volume tertiary teaching hospitals in China from 2016 to 2019. Propensity score matching (PSM) analysis and inverse probability of treatment weighting (IPTW) analysis was used to adjust for the imbalance in baseline characteristics. The primary research endpoint was the 3-year overall survival (OS) and disease-free survival (DFS). The secondary research endpoint was intraoperative outcomes and postoperative complications.

Results: After IPTW and PSM adjustments, baseline characteristics between the RG and LG groups were comparable [standardized mean difference (SMD) <0.10]. Post-PSM analysis revealed that the RG group exhibited longer operative time (P<0.001), lower postoperative complication rates (P<0.001), shorter postoperative hospital stays (P=0.037), and earlier initiation of adjuvant chemotherapy (P=0.041) compared with the LG group. Survival analysis demonstrated comparable 3-year OS (P=0.110) and DFS (P=0.088) in the PSM cohort, whereas the IPTW cohort showed superior OS (P=0.030) and DFS (P=0.046) for RG. No significant differences were observed in overall recurrence rates or recurrence sites between groups.

Conclusions: For patients with stage cT4a gastric cancer, compared with the LG group, the RG group had shorter postoperative hospital stay, lower incidence of postoperative complications, earlier postoperative adjuvant chemotherapy, and no worse long-term efficacy.

机器人与腹腔镜胃切除术治疗临床浆膜浸润性胃癌的短期和长期疗效比较:一项多中心队列研究
目的:机器人胃切除术(RG)在胃癌治疗中的应用越来越广泛。然而,对临床血清浸润性(cT4a)胃癌患者的研究仍然很少。本研究旨在比较RG和腹腔镜胃切除术(LG)治疗cT4a期胃癌的短期和长期疗效。方法:回顾性分析2016 - 2019年国内8家大容量三级教学医院诊治的cT4a期胃癌患者的临床资料。使用倾向评分匹配(PSM)分析和处理加权逆概率(IPTW)分析来调整基线特征的不平衡。主要研究终点是3年总生存期(OS)和无病生存期(DFS)。次要研究终点是术中结果和术后并发症。结果:经IPTW和PSM调整后,RG组和LG组的基线特征具有可比较性[标准化平均差(SMD)]结论:对于cT4a期胃癌患者,RG组术后住院时间较LG组短,术后并发症发生率较低,术后辅助化疗时间较LG组早,远期疗效无差。
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来源期刊
自引率
9.80%
发文量
1726
审稿时长
4.5 months
期刊介绍: Chinese Journal of Cancer Research (CJCR; Print ISSN: 1000-9604; Online ISSN:1993-0631) is published by AME Publishing Company in association with Chinese Anti-Cancer Association.It was launched in March 1995 as a quarterly publication and is now published bi-monthly since February 2013. CJCR is published bi-monthly in English, and is an international journal devoted to the life sciences and medical sciences. It publishes peer-reviewed original articles of basic investigations and clinical observations, reviews and brief communications providing a forum for the recent experimental and clinical advances in cancer research. This journal is indexed in Science Citation Index Expanded (SCIE), PubMed/PubMed Central (PMC), Scopus, SciSearch, Chemistry Abstracts (CA), the Excerpta Medica/EMBASE, Chinainfo, CNKI, CSCI, etc.
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