Robotic-assisted versus laparoscopic pancreaticoduodenectomy

oncological outcomes

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Minimally invasive pancreaticoduodenectomy (MIPD) is being performed with increasing frequency for pancreatic cancer, but the most oncologically efficacious surgical platform, whether robotic or laparoscopic, is yet to be determined. Currently, there are no national studies comparing the oncological outcomes between robotic (RPD) and laparoscopic (LPD) pancreaticoduodenectomy. Methods: This was a retrospective study using the National Cancer Database between 2010 and 2013. We compared the perioperative, pathological, and mid-term oncological outcomes between RPD and LPD. Results: There were 1623 MIPD cases, of which 90% were LPD and 10% were RPD. Most LPD (63%) and RPD (51%) cases were performed at institutions with a volume of ≤ 5 MIPDs per year. There were no differences in patient- and tumor-related factors between the groups. The majority of treated tumors were adenocarcinoma (90.1% for RPD and 89.1% for LPD). RPDs were more likely to be performed at academic centers (89.1%) compared to LPDs (68.1%, P < 0.001) and at higher-volume centers (median MIPD/year of 4.7 for RPD vs 3.6 for LPD, P < 0.001). There was no difference in the median number of examined lymph nodes, margin status, median length of stay, 90-day mortality, or 30-day readmission between groups. There was no difference in median overall survival for pancreatic adenocarcinoma between LPD (20.7 months) and RPD (22.7 months; log-rank P = 0.445). The 1- and 3-year overall survival rates were 74 and 31% for LPD and 71 and 33% for RPD. Conclusion: In this national cohort of patients, LPD and RPD were associated with equivalent perioperative, pathological, and mid-term oncological outcomes.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalSurgical Endoscopy and Other Interventional Techniques
DOIs
StateAccepted/In press - Dec 26 2017

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Pancreaticoduodenectomy
Robotics
Adenocarcinoma
Neoplasms
Pancreatic Neoplasms
Length of Stay
Survival Rate
Retrospective Studies
Lymph Nodes
Databases
Survival
Mortality

Keywords

  • Laparoscopic
  • Oncological outcome
  • Pancreaticoduodenectomy
  • Robotic

ASJC Scopus subject areas

  • Surgery

Cite this

@article{f03d477286ca4fd0bec35452ed81e4cd,
title = "Robotic-assisted versus laparoscopic pancreaticoduodenectomy: oncological outcomes",
abstract = "Background: Minimally invasive pancreaticoduodenectomy (MIPD) is being performed with increasing frequency for pancreatic cancer, but the most oncologically efficacious surgical platform, whether robotic or laparoscopic, is yet to be determined. Currently, there are no national studies comparing the oncological outcomes between robotic (RPD) and laparoscopic (LPD) pancreaticoduodenectomy. Methods: This was a retrospective study using the National Cancer Database between 2010 and 2013. We compared the perioperative, pathological, and mid-term oncological outcomes between RPD and LPD. Results: There were 1623 MIPD cases, of which 90{\%} were LPD and 10{\%} were RPD. Most LPD (63{\%}) and RPD (51{\%}) cases were performed at institutions with a volume of ≤ 5 MIPDs per year. There were no differences in patient- and tumor-related factors between the groups. The majority of treated tumors were adenocarcinoma (90.1{\%} for RPD and 89.1{\%} for LPD). RPDs were more likely to be performed at academic centers (89.1{\%}) compared to LPDs (68.1{\%}, P < 0.001) and at higher-volume centers (median MIPD/year of 4.7 for RPD vs 3.6 for LPD, P < 0.001). There was no difference in the median number of examined lymph nodes, margin status, median length of stay, 90-day mortality, or 30-day readmission between groups. There was no difference in median overall survival for pancreatic adenocarcinoma between LPD (20.7 months) and RPD (22.7 months; log-rank P = 0.445). The 1- and 3-year overall survival rates were 74 and 31{\%} for LPD and 71 and 33{\%} for RPD. Conclusion: In this national cohort of patients, LPD and RPD were associated with equivalent perioperative, pathological, and mid-term oncological outcomes.",
keywords = "Laparoscopic, Oncological outcome, Pancreaticoduodenectomy, Robotic",
author = "Ibrahim Nassour and Choti, {Michael A.} and Porembka, {Matthew R.} and Yopp, {Adam C.} and Wang, {Sam C.} and Polanco, {Patricio M.}",
year = "2017",
month = "12",
day = "26",
doi = "10.1007/s00464-017-6002-2",
language = "English (US)",
pages = "1--7",
journal = "Surgical Endoscopy and Other Interventional Techniques",
issn = "0930-2794",
publisher = "Springer New York",

}

TY - JOUR

T1 - Robotic-assisted versus laparoscopic pancreaticoduodenectomy

T2 - oncological outcomes

AU - Nassour, Ibrahim

AU - Choti, Michael A.

AU - Porembka, Matthew R.

AU - Yopp, Adam C.

AU - Wang, Sam C.

AU - Polanco, Patricio M.

PY - 2017/12/26

Y1 - 2017/12/26

N2 - Background: Minimally invasive pancreaticoduodenectomy (MIPD) is being performed with increasing frequency for pancreatic cancer, but the most oncologically efficacious surgical platform, whether robotic or laparoscopic, is yet to be determined. Currently, there are no national studies comparing the oncological outcomes between robotic (RPD) and laparoscopic (LPD) pancreaticoduodenectomy. Methods: This was a retrospective study using the National Cancer Database between 2010 and 2013. We compared the perioperative, pathological, and mid-term oncological outcomes between RPD and LPD. Results: There were 1623 MIPD cases, of which 90% were LPD and 10% were RPD. Most LPD (63%) and RPD (51%) cases were performed at institutions with a volume of ≤ 5 MIPDs per year. There were no differences in patient- and tumor-related factors between the groups. The majority of treated tumors were adenocarcinoma (90.1% for RPD and 89.1% for LPD). RPDs were more likely to be performed at academic centers (89.1%) compared to LPDs (68.1%, P < 0.001) and at higher-volume centers (median MIPD/year of 4.7 for RPD vs 3.6 for LPD, P < 0.001). There was no difference in the median number of examined lymph nodes, margin status, median length of stay, 90-day mortality, or 30-day readmission between groups. There was no difference in median overall survival for pancreatic adenocarcinoma between LPD (20.7 months) and RPD (22.7 months; log-rank P = 0.445). The 1- and 3-year overall survival rates were 74 and 31% for LPD and 71 and 33% for RPD. Conclusion: In this national cohort of patients, LPD and RPD were associated with equivalent perioperative, pathological, and mid-term oncological outcomes.

AB - Background: Minimally invasive pancreaticoduodenectomy (MIPD) is being performed with increasing frequency for pancreatic cancer, but the most oncologically efficacious surgical platform, whether robotic or laparoscopic, is yet to be determined. Currently, there are no national studies comparing the oncological outcomes between robotic (RPD) and laparoscopic (LPD) pancreaticoduodenectomy. Methods: This was a retrospective study using the National Cancer Database between 2010 and 2013. We compared the perioperative, pathological, and mid-term oncological outcomes between RPD and LPD. Results: There were 1623 MIPD cases, of which 90% were LPD and 10% were RPD. Most LPD (63%) and RPD (51%) cases were performed at institutions with a volume of ≤ 5 MIPDs per year. There were no differences in patient- and tumor-related factors between the groups. The majority of treated tumors were adenocarcinoma (90.1% for RPD and 89.1% for LPD). RPDs were more likely to be performed at academic centers (89.1%) compared to LPDs (68.1%, P < 0.001) and at higher-volume centers (median MIPD/year of 4.7 for RPD vs 3.6 for LPD, P < 0.001). There was no difference in the median number of examined lymph nodes, margin status, median length of stay, 90-day mortality, or 30-day readmission between groups. There was no difference in median overall survival for pancreatic adenocarcinoma between LPD (20.7 months) and RPD (22.7 months; log-rank P = 0.445). The 1- and 3-year overall survival rates were 74 and 31% for LPD and 71 and 33% for RPD. Conclusion: In this national cohort of patients, LPD and RPD were associated with equivalent perioperative, pathological, and mid-term oncological outcomes.

KW - Laparoscopic

KW - Oncological outcome

KW - Pancreaticoduodenectomy

KW - Robotic

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U2 - 10.1007/s00464-017-6002-2

DO - 10.1007/s00464-017-6002-2

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JF - Surgical Endoscopy and Other Interventional Techniques

SN - 0930-2794

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