Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Long-term Oncologic Outcomes of Robotic Total Gastrectomy for Advanced Gastric Cancer

  • Jawon Hwang (Department of Surgery, Yonsei University College of Medicine) ;
  • Ki-Yoon Kim (Department of Surgery, Yonsei University College of Medicine) ;
  • Sung Hyun Park (Department of Surgery, Yonsei University College of Medicine) ;
  • Minah Cho (Department of Surgery, Yonsei University College of Medicine) ;
  • Yoo Min Kim (Department of Surgery, Yonsei University College of Medicine) ;
  • Hyoung-Il Kim (Department of Surgery, Yonsei University College of Medicine) ;
  • Woo Jin Hyung (Department of Surgery, Yonsei University College of Medicine)
  • Received : 2024.07.10
  • Accepted : 2024.09.11
  • Published : 2024.10.01
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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.

Keywords

Acknowledgement

We acknowledge the assistance of BioScience Writers, LLC (Houston, TX, USA) for copy editing and correction of English language.

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