Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study

European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS); Jeffrey W. Chen; Tess M.E. van Ramshorst; Sanne Lof; Bilal Al-Sarireh; Bergthor Bjornsson; Ugo Boggi; Fernando Burdio; Giovanni Butturini; Riccardo Casadei; Andrea Coratti; Mathieu D’Hondt; Safi Dokmak; Bjørn Edwin; Alessandro Esposito; Jean M. Fabre; Giovanni Ferrari; Fadhel S. Ftériche; Giuseppe K. Fusai; Bas Groot Koerkamp; Thilo Hackert; Asif Jah; Jin Young Jang; Emanuele F. Kauffmann; Tobias Keck; Alberto Manzoni; Marco V. Marino; Quintus Molenaar; Elizabeth Pando; Patrick Pessaux; Andrea Pietrabissa; Zahir Soonawalla; Robert P. Sutcliffe; Lea Timmermann; Steven White; Vincent S. Yip; Alessandro Zerbi; Mohammad Abu Hilal; Marc G. Besselink; Thomas Malinka

doi:10.1245/s10434-022-13054-2

Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study

European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Jeffrey W. Chen, Tess M.E. van Ramshorst, Sanne Lof, Bilal Al-Sarireh, Bergthor Bjornsson, Ugo Boggi, Fernando Burdio, Giovanni Butturini, Riccardo Casadei, Andrea Coratti, Mathieu D’Hondt, Safi Dokmak, Bjørn Edwin, Alessandro Esposito, Jean M. Fabre, Giovanni Ferrari, Fadhel S. Ftériche, Giuseppe K. Fusai, Bas Groot KoerkampThilo Hackert, Asif Jah, Jin Young Jang, Emanuele F. Kauffmann, Tobias Keck, Alberto Manzoni, Marco V. Marino, Quintus Molenaar, Elizabeth Pando, Patrick Pessaux, Andrea Pietrabissa, Zahir Soonawalla, Robert P. Sutcliffe, Lea Timmermann, Steven White, Vincent S. Yip, Alessandro Zerbi, Mohammad Abu Hilal^*, Marc G. Besselink^*, Thomas Malinka

^*Corresponding author for this work

Applied Health Sciences

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Abstract

Background: Robot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking.

Methods: An international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010–2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival.

Results: In total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively.

Conclusions: In selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.

Original language	English
Pages (from-to)	3023-3032
Number of pages	10
Journal	Annals of Surgical Oncology
Volume	30
Issue number	5
Early online date	17 Feb 2023
DOIs	https://doi.org/10.1245/s10434-022-13054-2
Publication status	Published - May 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s).

ASJC Scopus subject areas

Surgery
Oncology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Chen, J. W., van Ramshorst, T. M. E., Lof, S., Al-Sarireh, B., Bjornsson, B., Boggi, U., Burdio, F., Butturini, G., Casadei, R., Coratti, A., D’Hondt, M., Dokmak, S., Edwin, B., Esposito, A., Fabre, J. M., Ferrari, G., Ftériche, F. S., Fusai, G. K., ... Malinka, T. (2023). Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study. Annals of Surgical Oncology, 30(5), 3023-3032. https://doi.org/10.1245/s10434-022-13054-2

@article{27f02940067b4b53b88dc72049d8101c,

title = "Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study",

abstract = "Background: Robot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking.Methods: An international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010–2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival.Results: In total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively.Conclusions: In selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.",

author = "{European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)} and Chen, {Jeffrey W.} and {van Ramshorst}, {Tess M.E.} and Sanne Lof and Bilal Al-Sarireh and Bergthor Bjornsson and Ugo Boggi and Fernando Burdio and Giovanni Butturini and Riccardo Casadei and Andrea Coratti and Mathieu D{\textquoteright}Hondt and Safi Dokmak and Bj{\o}rn Edwin and Alessandro Esposito and Fabre, {Jean M.} and Giovanni Ferrari and Ft{\'e}riche, {Fadhel S.} and Fusai, {Giuseppe K.} and {Groot Koerkamp}, Bas and Thilo Hackert and Asif Jah and Jang, {Jin Young} and Kauffmann, {Emanuele F.} and Tobias Keck and Alberto Manzoni and Marino, {Marco V.} and Quintus Molenaar and Elizabeth Pando and Patrick Pessaux and Andrea Pietrabissa and Zahir Soonawalla and Sutcliffe, {Robert P.} and Lea Timmermann and Steven White and Yip, {Vincent S.} and Alessandro Zerbi and {Abu Hilal}, Mohammad and Besselink, {Marc G.} and Beatrice Aussilhou and Kamarajah, {Sivesh K.} and {van Laarhoven}, Stijn and Thomas Malinka and Ravi Marudanayagam and Claudio Ricci and Patricia S{\'a}nchez-Vel{\'a}zquez",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = may,

doi = "10.1245/s10434-022-13054-2",

language = "English",

volume = "30",

pages = "3023--3032",

journal = "Annals of Surgical Oncology",

issn = "1068-9265",

publisher = "Springer",

number = "5",

}

European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Chen, JW, van Ramshorst, TME, Lof, S, Al-Sarireh, B, Bjornsson, B, Boggi, U, Burdio, F, Butturini, G, Casadei, R, Coratti, A, D’Hondt, M, Dokmak, S, Edwin, B, Esposito, A, Fabre, JM, Ferrari, G, Ftériche, FS, Fusai, GK, Groot Koerkamp, B, Hackert, T, Jah, A, Jang, JY, Kauffmann, EF, Keck, T, Manzoni, A, Marino, MV, Molenaar, Q, Pando, E, Pessaux, P, Pietrabissa, A, Soonawalla, Z, Sutcliffe, RP, Timmermann, L, White, S, Yip, VS, Zerbi, A, Abu Hilal, M, Besselink, MG & Malinka, T 2023, 'Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study', Annals of Surgical Oncology, vol. 30, no. 5, pp. 3023-3032. https://doi.org/10.1245/s10434-022-13054-2

Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study. / European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS); Chen, Jeffrey W.; van Ramshorst, Tess M.E. et al.
In: Annals of Surgical Oncology, Vol. 30, No. 5, 05.2023, p. 3023-3032.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer

T2 - An International, Retrospective, Cohort Study

AU - European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)

AU - Chen, Jeffrey W.

AU - van Ramshorst, Tess M.E.

AU - Lof, Sanne

AU - Al-Sarireh, Bilal

AU - Bjornsson, Bergthor

AU - Boggi, Ugo

AU - Burdio, Fernando

AU - Butturini, Giovanni

AU - Casadei, Riccardo

AU - Coratti, Andrea

AU - D’Hondt, Mathieu

AU - Dokmak, Safi

AU - Edwin, Bjørn

AU - Esposito, Alessandro

AU - Fabre, Jean M.

AU - Ferrari, Giovanni

AU - Ftériche, Fadhel S.

AU - Fusai, Giuseppe K.

AU - Groot Koerkamp, Bas

AU - Hackert, Thilo

AU - Jah, Asif

AU - Jang, Jin Young

AU - Kauffmann, Emanuele F.

AU - Keck, Tobias

AU - Manzoni, Alberto

AU - Marino, Marco V.

AU - Molenaar, Quintus

AU - Pando, Elizabeth

AU - Pessaux, Patrick

AU - Pietrabissa, Andrea

AU - Soonawalla, Zahir

AU - Sutcliffe, Robert P.

AU - Timmermann, Lea

AU - White, Steven

AU - Yip, Vincent S.

AU - Zerbi, Alessandro

AU - Abu Hilal, Mohammad

AU - Besselink, Marc G.

AU - Aussilhou, Beatrice

AU - Kamarajah, Sivesh K.

AU - van Laarhoven, Stijn

AU - Malinka, Thomas

AU - Marudanayagam, Ravi

AU - Ricci, Claudio

AU - Sánchez-Velázquez, Patricia

PY - 2023/5

Y1 - 2023/5

N2 - Background: Robot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking.Methods: An international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010–2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival.Results: In total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively.Conclusions: In selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.

AB - Background: Robot-assisted distal pancreatectomy (RDP) is increasingly used as an alternative to laparoscopic distal pancreatectomy (LDP) in patients with resectable pancreatic cancer but comparative multicenter studies confirming the safety and efficacy of RDP are lacking.Methods: An international, multicenter, retrospective, cohort study, including consecutive patients undergoing RDP and LDP for resectable pancreatic cancer in 33 experienced centers from 11 countries (2010–2019). The primary outcome was R0-resection. Secondary outcomes included lymph node yield, major complications, conversion rate, and overall survival.Results: In total, 542 patients after minimally invasive distal pancreatectomy were included: 103 RDP (19%) and 439 LDP (81%). The R0-resection rate was comparable (75.7% RDP vs. 69.3% LDP, p = 0.404). RDP was associated with longer operative time (290 vs. 240 min, p < 0.001), more vascular resections (7.6% vs. 2.7%, p = 0.030), lower conversion rate (4.9% vs. 17.3%, p = 0.001), more major complications (26.2% vs. 16.3%, p = 0.019), improved lymph node yield (18 vs. 16, p = 0.021), and longer hospital stay (10 vs. 8 days, p = 0.001). The 90-day mortality (1.9% vs. 0.7%, p = 0.268) and overall survival (median 28 vs. 31 months, p = 0.599) did not differ significantly between RDP and LDP, respectively.Conclusions: In selected patients with resectable pancreatic cancer, RDP and LDP provide a comparable R0-resection rate and overall survival in experienced centers. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.

UR - http://www.scopus.com/inward/record.url?scp=85147500022&partnerID=8YFLogxK

U2 - 10.1245/s10434-022-13054-2

DO - 10.1245/s10434-022-13054-2

M3 - Article

C2 - 36800127

AN - SCOPUS:85147500022

SN - 1068-9265

VL - 30

SP - 3023

EP - 3032

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

IS - 5

ER -

European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), Chen JW, van Ramshorst TME, Lof S, Al-Sarireh B, Bjornsson B et al. Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study. Annals of Surgical Oncology. 2023 May;30(5):3023-3032. Epub 2023 Feb 17. doi: 10.1245/s10434-022-13054-2

Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study

Abstract

Bibliographical note

ASJC Scopus subject areas

UN SDGs

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