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Long-term Oncologic Outcomes of Robotic Total Gastrectomy for Advanced Gastric Cancer

Authors
 Jawon Hwang  ;  Ki-Yoon Kim  ;  Sung Hyun Park  ;  Minah Cho  ;  Yoo Min Kim  ;  Hyoung-Il Kim  ;  Woo Jin Hyung 
Citation
 JOURNAL OF GASTRIC CANCER, Vol.24(4) : 451-463, 2024-10 
Journal Title
JOURNAL OF GASTRIC CANCER
ISSN
 2093-582X 
Issue Date
2024-10
MeSH
Aged ; Female ; Gastrectomy* / adverse effects ; Gastrectomy* / methods ; Humans ; Laparoscopy / adverse effects ; Laparoscopy / methods ; Male ; Middle Aged ; Retrospective Studies ; Robotic Surgical Procedures* / adverse effects ; Robotic Surgical Procedures* / methods ; Stomach Neoplasms* / mortality ; Stomach Neoplasms* / pathology ; Stomach Neoplasms* / surgery ; Survival Rate ; Treatment Outcome
Keywords
Gastrectomy ; Laparoscopy ; Prognosis ; Robot surgery ; Stomach neopla는
Abstract
Purpose: Although laparoscopic distal gastrectomy has rapidly replaced open distal gastrectomy, laparoscopic total gastrectomy (LTG) is less frequently performed owing to technical difficulties. Robotic surgery could be an appropriate minimally invasive alternative to LTG because it alleviates the technical challenges posed by laparoscopic procedures. However, few studies have compared the oncological safety of robotic total gastrectomy (RTG) with that of LTG, especially for advanced gastric cancer (AGC). Herein, we aimed to assess the oncological outcomes of RTG for AGC and compare them with those of LTG.

Materials and Methods: We retrospectively reviewed 147 and 204 patients who underwent RTG and LTG for AGC, respectively, between 2007 and 2020. Long-term outcomes were compared using inverse probability of treatment weighting (IPTW).

Results: After IPTW, the 2 groups exhibited similar clinicopathological features. The 5-year overall survival was comparable between the 2 groups (88.5% [95% confidence interval {CI}, 79.4%–93.7%] after RTG and 87.3% [95% CI, 80.1%–92.0%]) after LTG; log-rank P=0.544). The hazard ratio (HR) for death after RTG compared with that after LTG was 0.73 (95% CI, 0.40–1.33; P=0.304). The 5-year relapse-free survival was also similar between the 2 groups (75.7% [95% CI, 65.2%–83.4%] after RTG and 76.4% [95% CI, 67.9%–83.0%] after LTG; log-rank P=0.850). The HR for recurrence after RTG compared with that after LTG was 0.93 (95% CI, 0.60–1.46; P=0.753).

Conclusions: Our findings revealed that RTG and LTG for AGC had similar long-term outcomes. RTG is an oncologically safe alternative to LTG and has technical advantages.
Files in This Item:
T202406062.pdf Download
DOI
10.5230/jgc.2024.24.e38
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yoo Min(김유민)
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Park, Sung Hyun(박성현)
Cho, Minah(조민아) ORCID logo https://orcid.org/0000-0003-3011-5813
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/200881
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