Oncological outcomes of robotic pancreatectomy in patients with pancreatic cancer who receive adjuvant chemotherapy: A propensity score-matched retrospective cohort study. (August 2022)

• Record Type: Journal Article
• Authors: Weng, Yuanchi; Shen, Ziyun; Gemenetzis, Georgios; Jin, Jiabin; Chen, Haoda; Deng, Xiaxing; Peng, Chenghong; Shen, Baiyong
• Is Part Of: International journal of surgery. Volume 104(2022)
• Publication Date: 2022-08
• Subjects: Robotic pancreatectomy -- Open pancreatectomy -- Pancreatic ductal adenocarcinoma -- Adjuvant chemotherapy; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2022.106801
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Background: Limited data are available regarding long-term oncological outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) who undergo robotic pancreatectomy (RP). Method: All patients who underwent RP and open pancreatectomy (OP) for resectable PDAC between January 2011 and December 2019 were included. The RP group was matched 1:1 with OP group by propensity score matching (PSM). The oncological outcomes were collected and analyzed. Results: Overall, 1606 patients were included in this study. After PSM, a well-balanced cohort of 335 patients in each group was selected for further analysis. The RP group had shorter operative time (210 min vs. 240 min, P < 0.001), lower estimated blood loss (200 ml vs. 300 ml, P = 0.011), lower wound infection rates (4.5% vs. 10.1%, P = 0.005) and shorter length of postoperative hospital stay (15 days vs. 17 days, P = 0.001) compared to the OP group, with no significant differences in other perioperative outcomes. OS was comparable between the two groups (31 months vs. 28 months, P = 0.077); however, RFS was improved in the RP group (17 months vs. 14 months, P = 0.015). Subgroup analysis showed that patients who received adjuvant chemotherapy (AC) in the RP group had better RFS than the similar patient cohort in the OP group (17 months vs. 14 months, P = 0.024). Conclusion: Robotic pancreatectomy is safe and oncologically effective for resectable PDAC. OS was comparable between RP and OP, and RFS was improved in the RP group, especially in patients who receive AC. Highlights: A large sample including 1606 patients from a high-volume center. Recurrence-free survival (RFS) of the robotic group was better than the open group. The surgery-adjuvant chemotherapy interval was shorter in the robotic group. The chemotherapy completion rate was improved in robotic group.