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The RECOURSE Study: Long-term Oncologic Outcomes Associated With Robotically Assisted Minimally Invasive Procedures for Endometrial, Cervical, Colorectal, Lung, or Prostate Cancer: A Systematic Review and Meta-analysis.

Publication ,  Journal Article
Leitao, MM; Kreaden, US; Laudone, V; Park, BJ; Pappou, EP; Davis, JW; Rice, DC; Chang, GJ; Rossi, EC; Hebert, AE; Slee, A; Gonen, M
Published in: Ann Surg
March 1, 2023

OBJECTIVE: To assess long-term outcomes with robotic versus laparoscopic/thoracoscopic and open surgery for colorectal, urologic, endometrial, cervical, and thoracic cancers. BACKGROUND: Minimally invasive surgery provides perioperative benefits and similar oncological outcomes compared with open surgery. Recent robotic surgery data have questioned long-term benefits. METHODS: A systematic review and meta-analysis of cancer outcomes based on surgical approach was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using Pubmed, Scopus, and Embase. Hazard ratios for recurrence, disease-free survival (DFS), and overall survival (OS) were extracted/estimated using a hierarchical decision tree and pooled in RevMan 5.4 using inverse-variance fixed-effect (heterogeneity nonsignificant) or random effect models. RESULTS: Of 31,204 references, 199 were included (7 randomized, 23 database, 15 prospective, 154 retrospective studies)-157,876 robotic, 68,007 laparoscopic/thoracoscopic, and 234,649 open cases. Cervical cancer: OS and DFS were similar between robotic and laparoscopic [1.01 (0.56, 1.80), P =0.98] or open [1.18 (0.99, 1.41), P =0.06] surgery; 2 papers reported less recurrence with open surgery [2.30 (1.32, 4.01), P =0.003]. Endometrial cancer: the only significant result favored robotic over open surgery [OS; 0.77 (0.71, 0.83), P <0.001]. Lobectomy: DFS favored robotic over thoracoscopic surgery [0.74 (0.59, 0.93), P =0.009]; OS favored robotic over open surgery [0.93 (0.87, 1.00), P =0.04]. Prostatectomy: recurrence was less with robotic versus laparoscopic surgery [0.77 (0.68, 0.87), P <0.0001]; OS favored robotic over open surgery [0.78 (0.72, 0.85), P <0.0001]. Low-anterior resection: OS significantly favored robotic over laparoscopic [0.76 (0.63, 0.91), P =0.004] and open surgery [0.83 (0.74, 0.93), P =0.001]. CONCLUSIONS: Long-term outcomes were similar for robotic versus laparoscopic/thoracoscopic and open surgery, with no safety signal or indication requiring further research (PROSPERO Reg#CRD42021240519).

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

March 1, 2023

Volume

277

Issue

3

Start / End Page

387 / 396

Location

United States

Related Subject Headings

  • Surgery
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prospective Studies
  • Male
  • Lung
  • Laparoscopy
  • Humans
  • Colorectal Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Leitao, M. M., Kreaden, U. S., Laudone, V., Park, B. J., Pappou, E. P., Davis, J. W., … Gonen, M. (2023). The RECOURSE Study: Long-term Oncologic Outcomes Associated With Robotically Assisted Minimally Invasive Procedures for Endometrial, Cervical, Colorectal, Lung, or Prostate Cancer: A Systematic Review and Meta-analysis. Ann Surg, 277(3), 387–396. https://doi.org/10.1097/SLA.0000000000005698
Leitao, Mario M., Usha S. Kreaden, Vincent Laudone, Bernard J. Park, Emmanouil P. Pappou, John W. Davis, David C. Rice, et al. “The RECOURSE Study: Long-term Oncologic Outcomes Associated With Robotically Assisted Minimally Invasive Procedures for Endometrial, Cervical, Colorectal, Lung, or Prostate Cancer: A Systematic Review and Meta-analysis.Ann Surg 277, no. 3 (March 1, 2023): 387–96. https://doi.org/10.1097/SLA.0000000000005698.
Leitao MM, Kreaden US, Laudone V, Park BJ, Pappou EP, Davis JW, Rice DC, Chang GJ, Rossi EC, Hebert AE, Slee A, Gonen M. The RECOURSE Study: Long-term Oncologic Outcomes Associated With Robotically Assisted Minimally Invasive Procedures for Endometrial, Cervical, Colorectal, Lung, or Prostate Cancer: A Systematic Review and Meta-analysis. Ann Surg. 2023 Mar 1;277(3):387–396.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

March 1, 2023

Volume

277

Issue

3

Start / End Page

387 / 396

Location

United States

Related Subject Headings

  • Surgery
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prospective Studies
  • Male
  • Lung
  • Laparoscopy
  • Humans
  • Colorectal Neoplasms