• Jun Lu, Tai-Yuan Li, Li Zhang, Zu-Kai Wang, Jun-Jun She, Bao-Qing Jia, Xin-Gan Qin, Shuang-Yi Ren, Hong-Liang Yao, Ze-Ning Huang, Dong-Ning Liu, Han Liang, Fei-Yu Shi, Peng Li, Bo-Pei Li, Xin-Sheng Zhang, Kui-Jie Liu, Chao-Hui Zheng, Chang-Ming Huang, and Chinese Multi-center Research Group of Robotic Gastric Surgery.
• Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
• Ann. Surg. 2024 May 1; 279 (5): 808817808-817.

ObjectiveTo compare the short-term and long-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for gastric cancer.BackgroundThe clinical outcomes of RG over LG have not yet been effectively demonstrated.MethodsThis retrospective cohort study included 3599 patients with gastric cancer who underwent radical gastrectomy at eight high-volume hospitals in China from January 2015 to June 2019. Propensity score matching was performed between patients who received RG and LG. The primary end point was 3-year disease-free survival (DFS).ResultsAfter 1:1 propensity score matching, 1034 pairs of patients were enrolled in a balanced cohort for further analysis. The 3-year DFS in the RG and LG was 83.7% and 83.1% ( P =0.745), respectively, and the 3-year overall survival was 85.2% and 84.4%, respectively ( P =0.647). During 3 years of follow-up, 154 patients in the RG and LG groups relapsed (cumulative incidence of recurrence: 15.0% vs 15.0%, P =0.988). There was no significant difference in the recurrence sites between the 2 groups (all P >0.05). Sensitivity analysis showed that RG had comparable 3-year DFS (77.4% vs 76.7%, P =0.745) and overall survival (79.7% vs 78.4%, P =0.577) to LG in patients with advanced (pathologic T2-4a) disease, and the recurrence pattern within 3 years was also similar between the 2 groups (all P >0.05). RG had less intraoperative blood loss, lower conversion rate, and shorter hospital stays than LG (all P >0.05).ConclusionsFor resectable gastric cancer, including advanced cases, RG is a safe approach with comparable 3-year oncological outcomes to LG when performed by experienced surgeons.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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