机器人与腹腔镜胃癌根治术的长期肿瘤学结果：多中心队列研究。

Long-term oncological outcomes of robotic versus laparoscopic gastrectomy for gastric cancer: multicentre cohort study.

机构信息

Department of General Surgery, Centre for Minimally Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China.

Department of General Surgery, Chinese PLA General Hospital First Medical Centre, Beijing, China.

出版信息

Br J Surg. 2024 Jan 3;111(1). doi: 10.1093/bjs/znad435.

DOI:10.1093/bjs/znad435

PMID:38215239

Abstract

BACKGROUND

The aim of this multicentre cohort study was to compare the long-term oncological outcomes of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for patients with gastric cancer.

METHODS

Patients with gastric cancer who underwent radical gastrectomy by robotic or laparoscopic approaches from 1 March 2010 to 31 December 2018 at 10 high-volume centres in China were selected from institutional databases. Patients receiving RG were matched 1 : 1 by propensity score with patients undergoing LG. The primary outcome was 3-year disease-free survival. Secondary outcomes were overall survival and disease recurrence.

RESULTS

Some 2055 patients who underwent RG and 4309 patients who had LG were included. The propensity score-matched cohort comprised 2026 RGs and 2026 LGs. Median follow-up was 41 (i.q.r. 39-58) months for the RG group and 39 (38-56) months for the LG group. The 3-year disease-free survival rates were 80.8% in the RG group and 79.5% in the LG group (log rank P = 0.240; HR 0.92, 95% c.i. 0.80 to 1.06; P = 0.242). Three-year OS rates were 83.9 and 81.8% respectively (log rank P = 0.068; HR 0.87, 0.75 to 1.01; P = 0.068) and the cumulative incidence of recurrence over 3 years was 19.3% versus 20.8% (HR 0.95, 0.88 to 1.03; P = 0.219), with no difference between groups.

CONCLUSION

RG and LG in patients with gastric cancer are associated with comparable disease-free and overall survival.

摘要

背景

本多中心队列研究旨在比较机器人胃切除术（RG）和腹腔镜胃切除术（LG）治疗胃癌患者的长期肿瘤学结果。

方法

从 2010 年 3 月 1 日至 2018 年 12 月 31 日，从中国 10 个大容量中心的机构数据库中选择接受机器人或腹腔镜根治性胃切除术的胃癌患者。通过倾向评分，将接受 RG 的患者与接受 LG 的患者 1:1 匹配。主要结局是 3 年无病生存率。次要结局是总生存率和疾病复发率。

结果

共有 2055 例接受 RG 和 4309 例接受 LG 的患者纳入研究。倾向评分匹配队列包括 2026 例 RG 和 2026 例 LG。RG 组的中位随访时间为 41（IQR 39-58）个月，LG 组为 39（38-56）个月。RG 组的 3 年无病生存率为 80.8%，LG 组为 79.5%（对数秩 P = 0.240；HR 0.92，95%CI 0.80 至 1.06；P = 0.242）。3 年 OS 率分别为 83.9%和 81.8%（对数秩 P = 0.068；HR 0.87，0.75 至 1.01；P = 0.068），3 年内复发累积发生率分别为 19.3%和 20.8%（HR 0.95，0.88 至 1.03；P = 0.219），两组间无差异。