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Background <p>The primary treatment for gastric cancer (GC) is surgical resection, particularly for locally advanced cases. While laparoscopic gastrectomy (LG) has shown short- and long-term benefits, robotic gastrectomy (RG) offers enhanced precision and may lead to better outcomes, especially in advanced-stage disease.</p> Methods <p>This retrospective study analyzed data from 1538 patients with pathological Stage I-III GC who underwent RG or LG between 2014 and 2021. Propensity score matching created 466 matched pairs. Perioperative outcomes, 3&#xa0;year overall survival (OS), 3&#xa0;year recurrence-free survival (RFS), and recurrence patterns were compared between RG and LG.</p> Results <p>RG demonstrated significantly shorter operative time (235.5 vs. 242.5&#xa0;min, p = 0.001), less blood loss (19.1 vs. 33.4&#xa0;ml, p &lt; 0.001), and shorter hospital stay (7.9 vs. 9.7&#xa0;days, p &lt; 0.001). Overall complications did not differ significantly (p = 0.183), but RG had lower rates of anastomotic leakage (p = 0.045) and pancreatic fistula (p = 0.024).</p> <p>No significant differences in OS were observed in the overall cohort or by stage. Similarly, RFS showed no significant differences in the overall cohort (3&#xa0;year RFS: RG 86.81% vs. LG 83.04%, p = 0.1347). By stage, no differences were found in stage I or II, but in stage III, RG showed better 3&#xa0;year RFS (67.52% vs. 52.97%, p = 0.0424). RG also had lower recurrence rates (9.0% vs. 14.8%, p = 0.0061), with fewer liver (p = 0.0069) and lymph node metastases (p = 0.0223).</p> Conclusion <p>RG demonstrated superior short-term outcomes and comparable three-year OS to laparoscopic gastrectomy, with improved three-year RFS and reduced recurrence in Stage III, likely facilitated by earlier adjuvant chemotherapy initiation.</p>

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Robotic and laparoscopic gastrectomy for gastric cancer: comparative insights into perioperative performance and three-year survival outcomes

  • 期刊论文

  • 发表日期：

    2025年2月26日

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  • Yuki Ushimaru,
  • Takeshi Omori,
  • Kazuyoshi Yamamoto,
  • Yoshitomo Yanagimoto,
  • Yasunori Masuike,
  • Norihiro Matsuura,
  • Takahito Sugase,
  • Takashi Kanemura,
  • Ryota Mori,
  • Masatoshi Kitakaze,
  • Masataka Amisaki,
  • Masahiko Kubo,
  • Yousuke Mukai,
  • Hisateru Komatsu,
  • Toshinori Sueda,
  • Yoshinori Kagawa,
  • Hiroshi Wada,
  • Kunihito Gotoh,
  • Masayoshi Yasui,
  • Hiroshi Miyata

摘要

Background

The primary treatment for gastric cancer (GC) is surgical resection, particularly for locally advanced cases. While laparoscopic gastrectomy (LG) has shown short- and long-term benefits, robotic gastrectomy (RG) offers enhanced precision and may lead to better outcomes, especially in advanced-stage disease.

Methods

This retrospective study analyzed data from 1538 patients with pathological Stage I-III GC who underwent RG or LG between 2014 and 2021. Propensity score matching created 466 matched pairs. Perioperative outcomes, 3 year overall survival (OS), 3 year recurrence-free survival (RFS), and recurrence patterns were compared between RG and LG.

Results

RG demonstrated significantly shorter operative time (235.5 vs. 242.5 min, p = 0.001), less blood loss (19.1 vs. 33.4 ml, p < 0.001), and shorter hospital stay (7.9 vs. 9.7 days, p < 0.001). Overall complications did not differ significantly (p = 0.183), but RG had lower rates of anastomotic leakage (p = 0.045) and pancreatic fistula (p = 0.024).

No significant differences in OS were observed in the overall cohort or by stage. Similarly, RFS showed no significant differences in the overall cohort (3 year RFS: RG 86.81% vs. LG 83.04%, p = 0.1347). By stage, no differences were found in stage I or II, but in stage III, RG showed better 3 year RFS (67.52% vs. 52.97%, p = 0.0424). RG also had lower recurrence rates (9.0% vs. 14.8%, p = 0.0061), with fewer liver (p = 0.0069) and lymph node metastases (p = 0.0223).

Conclusion

RG demonstrated superior short-term outcomes and comparable three-year OS to laparoscopic gastrectomy, with improved three-year RFS and reduced recurrence in Stage III, likely facilitated by earlier adjuvant chemotherapy initiation.