Advantages of robotic surgery for advanced gastric cancer in short-term outcomes: A single-center retrospective study using propensity score matching.

Abstract

343 Background: The advantages of robotic gastrectomy (RG) for gastric cancer are being demonstrated. However, there are few reports that have focused on advanced gastric cancer and examined the advantages of RG for laparoscopic gastrectomy (LG). We conducted the following study to clarify the advantages of RG for advanced gastric cancer. Methods: This single-center retrospective study reviewed the clinical data of 1531 patients who underwent either RG or LG from 2014 to 2023. 473 patients were with clinically diagnoses as having advanced gastric cancer. They were divided into the RG group (n = 143) and the LG group (n = 330). Propensity score matching was employed to adjust the background of the two groups, as covariates of age, gender, BMI, surgical method (distal gastrectomy/total gastrectomy), stage (early cancer/advanced cancer), and presence or absence of preoperative chemotherapy. Then, the treatment results were compared and examined. Results: 130 patients in each group were extracted by propensity score matching. There were no significant differences in age, gender, and ECOG-PS between the two groups. Compared to the LG group, the RG group had more cases with deeper invasion depth ≥T3 (93.1 vs 84.6%, P = 0.04), more D2 dissection (96.9 vs 88.5%, P = 0.01), and longer operative time (339.5 vs 294.5min, P <0.01). The number of retrieved lymph nodes was larger (49.5 vs. 44, P <0.01) in the RG group. Importantly, in the RG group, there were fewer complications with Clavien-Dindo (CD) classification ≥Grade II (11.5 vs 21.5%, P = 0.04) and CD classification ≥Grade III (0.8% vs 6.9%, P = 0.01). Postoperative hospital stay was shorter (8 vs 9 days, P = 0.01) in the RG group. Conclusions: RG for advanced gastric cancer has the potential to reduce complications compared to LG. Long-term survival outcomes should be investigated.