Comparison of short- and long-term outcomes for robotic versus laparoscopic gastrectomy in elderly patients with gastric cancer: a multicenter cohort study.

[BACKGROUND] There is limited evidence from large-scale multicenter studies regarding the short- and long-term efficacy of robotic gastrectomy (RG) in elderly patients diagnosed with gastric cancer (GC). As such, this retrospective investigation compared short-term outcomes and long-term oncological prognoses of RG versus (vs.) laparoscopic gastrectomy (LG) in a representative sample of this population.

[METHODS] Data from 1393 patients ≥ 65 years of age diagnosed with GC, who underwent radical gastrectomy at 8 large tertiary hospitals in China between August 2016 and June 2019, were analyzed. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were used to reduce confounding bias.

[RESULTS] After IPTW and PSM adjustments, baseline characteristics between the RG and LG groups were comparable (standardized mean difference < 0.10). After IPTW adjustment, mean blood loss in the RG group was significantly less than that in the LG group (89.36 vs. 103.39 mL; p = 0.046) as was mean length of hospital stay (9.62 vs. 10.47 days; p = 0.017). There were no statistical differences in postoperative complications between the RG and LG groups (p > 0.05), nor in 3y-DFS (IPTW-adjusted: 74.5% vs. 74.6%, p = 0.957; PSM-adjusted: 76.8% vs. 79.3%, p = 0.323) or 3y-OS (IPTW-adjusted: 75.9% vs. 77.0%, p = 0.640; PSM-adjusted: 77.9% vs. 80.9%, p = 0.235). Similarly, there were no significant differences in postoperative recurrence rates between the RG and LG groups (IPTW-adjusted: 21.1% vs. 20.5%, p = 0.640; PSM-adjusted: 77.9% vs. 80.9%, p = 0.235).

[CONCLUSION] RG yielded superior short-term outcomes compared with LG in elderly patients diagnosed with GC, while achieving comparable long-term outcomes and demonstrating safety and effectiveness.