Long-Term and Oncologic Outcomes of Robotic Versus Laparoscopic Liver Resection for Metastatic Colorectal Cancer: A Multicenter, Propensity Score Matching Analysis

• Published in: World journal of surgery Vol. 44; no. 3; pp. 887 - 895
• Main Authors: Beard, Rachel E., Khan, Sidrah, Troisi, Roberto I., Montalti, Roberto, Vanlander, Aude, Fong, Yuman, Kingham, T. Peter, Boerner, Thomas, Berber, Eren, Kahramangil, Bora, Buell, Joseph F., Martinie, John B., Vrochides, Dionisios, Shen, Chengli, Molinari, Michele, Geller, David A., Tsung, Allan
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-03-2020; Springer Nature B.V
• Subjects: Abdominal Surgery; Aged; Cancer; Cardiac Surgery; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - pathology; Critical Care; Disease-Free Survival; Female; General Surgery; Hepatectomy; Hepatectomy - adverse effects; Hepatectomy - methods; Humans; Laparoscopy; Laparoscopy - adverse effects; Length of Stay; Liver; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Margins of Excision; Matching; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Morbidity; Neoplasm Recurrence, Local - surgery; Original Scientific Report; Patient Readmission; Propensity Score; Reoperation; Retrospective Studies; Robotic Surgical Procedures - adverse effects; Surgery; Survival; Thoracic Surgery; Time Factors; Treatment Outcome; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-019-05270-x

Background
To assess long-term oncologic outcomes of robotic-assisted liver resection (RLR) for colorectal cancer (CRC) metastases as compared to a propensity-matched cohort of laparoscopic liver resections (LLR). Although safety and short-term outcomes of RLR have been described and previously compared to LLR, long-term and oncologic data are lacking.
Methods
A retrospective study was performed of all patients who underwent RLR and LLR for CRC metastases at six high-volume centers in the USA and Europe between 2002 and 2017. Propensity matching was used to match baseline characteristics between the two groups. Data were analyzed with a focus on postoperative and oncologic outcomes, as well as long-term recurrence and survival.
Results
RLR was performed in 115 patients, and 514 patients underwent LLR. Following propensity matching 115 patients in each cohort were compared. Perioperative outcomes including mortality, morbidity, reoperation, readmission, intensive care requirement, length-of-stay and margin status were not statistically different. Both prematching and postmatching analyses demonstrated similar overall survival (OS) and disease-free survival (DFS) between RLR and LLR at 5 years (61 vs. 60% OS,
p
 = 0.87, and 38 vs. 31% DFS,
p
 = 0.25, prematching; 61 vs. 60% OS,
p
 = 0.78, and 38 vs. 44% DFS,
p
 = 0.62, postmatching).
Conclusions
Propensity score matching with a large, multicenter database demonstrates that RLR for colorectal metastases is feasible and safe, with perioperative and long-term oncologic outcomes and survival that are largely comparable to LLR.