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

Jeffrey W Chen; Tess M E van Ramshorst; European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS); 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

doi:10.1245/s10434-022-13054-2

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

Jeffrey W Chen
, Tess M E van Ramshorst
, European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)
, 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^*

^*Corresponding author for this work

Surgery

Amsterdam UMC, Locatie VUmc
Morriston Hospital
Linköping University
SOD Genetica Molecolare, University Hospital of Pisa
University Hospital del Mar
Pederzoli Hospital
Sant'Orsola Malphigi Hospital
Azienda Ospedaliera Careggi
Groeninge Hospital
Beaujon Hospital
The Norwegian Radium Hospital
Integrated University Hospital of Verona
Saint-Éloi Hospital
Asst Grande Ospedale Metropolitano Niguarda
HPB & Liver Transplant Unit
University Hospital Heidelberg
Cambridge University Hospitals NHS Foundation Trust
Seoul National University Children’s Hospital
University Medical Centre Schleswig-Holstein
Department of General Surgery
Ospedali Riuniti Villa Sofia-Cervello
University Medical Centre Utrecht
Vall d'Hebron Institute of Oncology
Institut Hospitalo-Universitaire de Strasbourg
Department of Orthopedic Surgery
Oxford University Hospitals NHS Foundation Trust
Queen Elizabeth University Hospital (Birmingham)
The Freeman Hospital Newcastle Upon Tyne
The Royal London Hospital
Humanitas University and IRCCS Humanitas Research Hospital
Amsterdam UMC
Cancer Center Amsterdam (CCA)

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

39 Citations (Scopus)

49 Downloads (Pure)

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	Feb 2023
DOIs	https://doi.org/10.1245/s10434-022-13054-2
Publication status	Published - May 2023

Bibliographical note

Funding Information:
For the European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) Collaborators: Beatrice Aussilhou, MD, PhD12, Sivesh K. Kamarajah, MD, PhD31, Stijn van Laarhoven, MD, PhD20, Thomas Malinka, MD, PhD30, Ravi Marudanayagam, MD, PhD29, Claudio Ricci, MD, PhD9, Patricia Sánchez-Velázquez, MD, PhD7.

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

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Chen, J. W., van Ramshorst, T. M. E., European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), 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., ... Besselink, M. G. (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{f36f640c43ce41918add14327e80fef9,

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 = "Chen, \{Jeffrey W\} and \{van Ramshorst\}, \{Tess M E\} and \{European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)\} 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'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 Jin-Young Jang 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\}",

note = "Funding Information: For the European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) Collaborators: Beatrice Aussilhou, MD, PhD12, Sivesh K. Kamarajah, MD, PhD31, Stijn van Laarhoven, MD, PhD20, Thomas Malinka, MD, PhD30, Ravi Marudanayagam, MD, PhD29, Claudio Ricci, MD, PhD9, Patricia S{\'a}nchez-Vel{\'a}zquez, MD, PhD7. 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 Science+Business Media",

number = "5",

}

Chen, JW, van Ramshorst, TME, European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), 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, J-Y, 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 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. / Chen, Jeffrey W; van Ramshorst, Tess M E; European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) et al.
In: Annals of Surgical Oncology, Vol. 30, No. 5, 05.2023, p. 3023-3032.

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

TY - JOUR

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

T2 - An International, Retrospective, Cohort Study

AU - Chen, Jeffrey W

AU - van Ramshorst, Tess M E

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

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

N1 - Funding Information: For the European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) Collaborators: Beatrice Aussilhou, MD, PhD12, Sivesh K. Kamarajah, MD, PhD31, Stijn van Laarhoven, MD, PhD20, Thomas Malinka, MD, PhD30, Ravi Marudanayagam, MD, PhD29, Claudio Ricci, MD, PhD9, Patricia Sánchez-Velázquez, MD, PhD7. Publisher Copyright: © 2023, The Author(s).

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.

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UR - https://www.scopus.com/pages/publications/85147500022

U2 - 10.1245/s10434-022-13054-2

DO - 10.1245/s10434-022-13054-2

M3 - Article

C2 - 36800127

SN - 1068-9265

VL - 30

SP - 3023

EP - 3032

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

IS - 5

ER -

Chen JW, van Ramshorst TME, European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS), 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. 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

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