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 Review
| Authors: | Leitao, M. M. Jr; Kreaden, U. S.; Laudone, V.; Park, B. J.; Pappou, E. P.; Davis, J. W.; Rice, D. C.; Chang, G. J.; Rossi, E. C.; Hebert, A. E.; Slee, A.; Gonen, M. |
| Review Title: | 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 |
| Abstract: | 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). |
| Keywords: | survival; endometrial cancer; hysterectomy; colorectal cancer; surgery; radical prostatectomy; outcomes; cervical cancer; follow-up; trial; rectal-cancer; pathological; open surgery; thoracic cancer; robotic-assisted; urologic cancer; open resection |
| Journal Title: | Annals of Surgery |
| Volume: | 277 |
| Issue: | 3 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2023-03-01 |
| Start Page: | 387 |
| End Page: | 396 |
| Language: | English |
| ACCESSION: | WOS:000928273100039 |
| DOI: | 10.1097/sla.0000000000005698 |
| PROVIDER: | wos |
| PMCID: | PMC9905254 |
| PUBMED: | 36073772 |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Mario M. Leitao -- Source: Wos |
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