Masaya Nakauchi, Koichi Suda, Kenji Kikuchi, Shinichi Kadoya, Kazuki Inaba, Ichiro Uyama. Fujita Health University
Background: More than 4000 da Vinci Surgical Systems (DVSS) have been installed worldwide. However, robotic gastrectomy (RG) reportedly has the disadvantages of longer operative time and higher cost compared with laparoscopic gastrectomy (LG). We previously examined 3-year outcomes of RG and LG and reported the oncological feasibility in RG. This study aimed to determine the 5-year oncological outcomes between RG and LG for GC.
Methods: Of the 521 consecutive patients with GC who underwent radical gastrectomy at our institution between 2009 and 2012, 84 consecutive patients who underwent RG and 437 patients who received LG were enrolled in this study. Long-term outcomes including the 5-year overall survival (5yOS) and 5-year recurrence-free survival rates (5yRFS) were retrospectively examined using the entire and propensity-score matched cohort.
Results: No differences in 5yOS (RG, 84.5 % vs. LG, 83.3 %; p = 0.932) or 5yRFS (RG, 84.5 % vs. LG, 81.0 %; p = 0.615) were observed between the groups. In the RG group, the 5yOS rates stratified by pathological stage according to the Japanese classification of gastric carcinoma (IA, IB, II, and III) were 94.7, 81.8, 89.5, and 56.3 %, respectively. In multivariate analysis, morbidity of Clavien-Dindo Classification III or more was significantly related to 5yOS in pathological stage 0-IB group (HR 5.53, 95%CI [1.26-24.31], p = 0.024), and the usage of robot was significant factor to improve 5yRFS in pathological stage II-III group (HR0.46, 95%CI [0.22-0.97], p = 0.041).
Conclusion: RG for GC was feasible and safe from the 5-year oncological point of view. The surgical robot might be beneficial especially in advanced diseases.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95848
Program Number: S156
Presentation Session: Plenary II
Presentation Type: Podium