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Long-term Comparison of Robotic and Laparoscopic Gastrectomy for Gastric Cancer: A Propensity Score-weighted Analysis of 2084 Consecutive Patients

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dc.contributor.authorShin, HJ-
dc.contributor.authorSon, SY-
dc.contributor.authorWang, B-
dc.contributor.authorRoh, CK-
dc.contributor.authorHur, H-
dc.contributor.authorHan, SU-
dc.date.accessioned2023-01-10T00:38:46Z-
dc.date.available2023-01-10T00:38:46Z-
dc.date.issued2021-
dc.identifier.issn0003-4932-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/23809-
dc.description.abstractOBJECTIVE: To compare long-term outcomes between robotic and LG approaches using propensity score weighting based on a generalized boosted method to control for selection bias. SUMMARY OF BACKGROUND DATA: Minimally invasive surgical approaches for GC are increasing, yet limited evidence exists for long-term outcomes of robotic gastrectomy (RG). METHODS: Patients (n = 2084) with GC stages I-III who underwent LG or RG between 2009 and 2017 were analyzed. Generalized boosted method was used to estimate a propensity score derived from all available preoperative characteristics. Long-term outcomes were compared using the adjusted Kaplan-Meier method and the weighted Cox proportional hazards regression model. RESULTS: After propensity score weighting, the population was balanced. Patients who underwent RG showed reduced blood loss (16 mL less, P = 0.025), sufficient lymph node harvest from the initial period, and no changes in surgical outcomes over time. With 52-month median follow-up, no difference was noted in 5-year overall survival in unweighted [91.5% in LG vs 94% in RG; hazard ratio (HR), 0.71; 95% confidence interval (CI), 0.46-1.1; P = 0.126] and weighted populations (94.2% in LG vs 93.2% in RG; HR, 0.88; 95% CI, 0.52-1.48; P = 0.636). There were no differences in 5-year recurrence-free survival (RFS), with unweighted 5-year RFS of 95.4% for LG and 95.2% for RG (HR, 0.95; 95% CI, 0.55-1.64; P = 0.845) and weighted 5-year RFS of 96.3% for LG and 95.3% for RG (HR, 1.24; 95% CI, 0.66-2.33; P = 0.498). CONCLUSIONS: After balancing covariates, RG demonstrated reliable surgical outcomes from the beginning. Long-term survival after RG and LG for GC was similar.-
dc.language.isoen-
dc.subject.MESHAged-
dc.subject.MESHBlood Loss, Surgical-
dc.subject.MESHDisease-Free Survival-
dc.subject.MESHFemale-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHGastrectomy-
dc.subject.MESHHumans-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHLaparoscopy-
dc.subject.MESHLymph Node Excision-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNeoplasm Staging-
dc.subject.MESHPropensity Score-
dc.subject.MESHProportional Hazards Models-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRobotic Surgical Procedures-
dc.subject.MESHStomach Neoplasms-
dc.titleLong-term Comparison of Robotic and Laparoscopic Gastrectomy for Gastric Cancer: A Propensity Score-weighted Analysis of 2084 Consecutive Patients-
dc.typeArticle-
dc.identifier.pmid32187032-
dc.contributor.affiliatedAuthorShin, HJ-
dc.contributor.affiliatedAuthorSon, SY-
dc.contributor.affiliatedAuthorRoh, CK-
dc.contributor.affiliatedAuthorHur, H-
dc.contributor.affiliatedAuthorHan, SU-
dc.type.localJournal Papers-
dc.identifier.doi10.1097/SLA.0000000000003845-
dc.citation.titleAnnals of surgery-
dc.citation.volume274-
dc.citation.number1-
dc.citation.date2021-
dc.citation.startPage128-
dc.citation.endPage137-
dc.identifier.bibliographicCitationAnnals of surgery, 274(1). : 128-137, 2021-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1528-1140-
dc.relation.journalidJ000034932-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
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