晚期胃癌机器人全胃切除术的长期肿瘤学疗效

IF 3.2 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastric Cancer Pub Date : 2024-10-01 DOI:10.5230/jgc.2024.24.e38
Jawon Hwang, Ki-Yoon Kim, Sung Hyun Park, Minah Cho, Yoo Min Kim, Hyoung-Il Kim, Woo Jin Hyung
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引用次数: 0

摘要

目的:虽然腹腔镜远端胃切除术已迅速取代了开腹远端胃切除术,但由于技术上的困难,腹腔镜全胃切除术(LTG)却较少实施。机器人手术可以缓解腹腔镜手术带来的技术难题,因此可以作为 LTG 的微创替代手术。然而,很少有研究对机器人全胃切除术(RTG)与LTG的肿瘤安全性进行比较,尤其是针对晚期胃癌(AGC)。在此,我们旨在评估RTG治疗AGC的肿瘤学结果,并与LTG进行比较:我们回顾性研究了 2007 年至 2020 年间分别接受 RTG 和 LTG 治疗的 147 例和 204 例 AGC 患者。采用逆治疗概率加权法(IPTW)对长期结果进行了比较:结果:IPTW后,两组患者的临床病理特征相似。两组的 5 年总生存率相当(RTG 后为 88.5% [95% 置信区间 {CI},79.4%-93.7%],LTG 后为 87.3% [95% CI,80.1%-92.0%];log-rank P=0.544)。与LTG相比,RTG后死亡的危险比(HR)为0.73(95% CI,0.40-1.33;P=0.304)。两组患者的 5 年无复发生存率也相似(RTG 后为 75.7% [95% CI, 65.2%-83.4%] ,LTG 后为 76.4% [95% CI, 67.9%-83.0%]; log-rank P=0.850)。与LTG相比,RTG后复发的HR为0.93(95% CI,0.60-1.46;P=0.753):我们的研究结果表明,RTG和LTG治疗AGC的长期疗效相似。我们的研究结果表明,RTG 和 LTG 治疗 AGC 的远期疗效相似。RTG 是一种肿瘤学上安全的 LTG 替代方案,并且具有技术优势。
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Long-term Oncologic Outcomes of Robotic Total Gastrectomy for Advanced Gastric Cancer.

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.

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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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