Robot-assisted surgery for gastric carcinoma: Five years follow-up and beyond

• Published in: European journal of surgical oncology 2015-08, Vol.41 (8), p.1106-1113
• Main Authors: Coratti, A, Fernandes, E, Lombardi, A, Di Marino, M, Annecchiarico, M, Felicioni, L, Giulianotti, P.C
• Format: Article
• Language: English
• Subjects: Gastrectomy; Gastric cancer; Hematology, Oncology and Palliative Medicine; Robotic surgery; Surgery; Survival
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2015.01.014

Abstract Introduction Robot-assisted surgery for the treatment of gastric cancer is considered to be safe and feasible with early post-operative outcomes comparable to open and laparoscopic series. However, data regarding long-term oncological outcomes are lacking. Aim of this study is to evaluate long-term oncological outcomes of a cohort of gastric cancer patients treated surgically with the robot-assisted approach. Materials and methods A prospectively collected database of robot-assisted gastrectomies performed for gastric cancer at the ‘Misericordia Hospital’ between September 2001 and October 2011 was retrospectively analysed. Data regarding surgical procedures, early postoperative course, and long-term follow-up were analysed. Results The study included 98 consecutive robot-assisted gastrectomies. Fifty-nine distal gastrectomies, 38 total gastrectomies, and 1 proximal gastrectomy. Open conversion occurred in seven patients (7.1%) due to locally advanced disease. Postoperative morbidity and mortality were 12.2% and 4.1% respectively. Post-operative staging showed 46 patients (46.9%) with stage I disease, 25 patients (25.5%) with stage II, 26 (26.5%) with stage III and 1 (1.02%) with stage IV. The mean follow-up was 46.9 months. Cumulative 5-year overall survival (OS) was 73.3% (95% CI: 62.2–84.4). Five-year survival by stage subgroups was 100% for patients with stage IA, 84.6% for stage IB, 76.9% for stage II, and 21.5% for stage III. The only patient in stage IV of this series died eight months after surgery. Conclusions Robot-assisted gastrectomy for the treatment of gastric cancer is safe and feasible. It provides long-term outcomes comparable to most open and laparoscopic series. Further studies are necessary to better define its indication.