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- Title
Effect of surgical approach on early return to intended oncologic therapy after resection for pancreatic ductal adenocarcinoma.
- Authors
Lu, Pamela W.; Lyu, Heather G.; Prakash, Laura R.; Chiang, Yi-Ju Sabrina; Maxwell, Jessica E.; Snyder, Rebecca A.; Kim, Michael P.; Tzeng, Ching-Wei D.; Katz, Matthew H. G.; Ikoma, Naruhiko
- Abstract
Background: Although robotic pancreatectomy may facilitate an earlier functional recovery, the impact of a robotic pancreatectomy program during its early experience on the timing of return to intended oncologic therapy (RIOT) after surgery is unknown. Methods: In this retrospective cohort study, we used propensity score matching with a 1:2 ratio to compare patients who underwent robotic or open surgery (distal pancreatectomy or pancreatoduodenectomy) for pancreatic ductal adenocarcinoma (PDAC) during the first 3 years of our robotic pancreatectomy experience (January 2018–December 2021). Generalized estimating equations modeling was used to evaluate the effect of surgical approach on early RIOT, defined as adjuvant chemotherapy initiation within 8 weeks after surgery, and late RIOT, defined as initiation within 12 weeks after surgery. Results: The matched cohort included 26 patients who underwent robotic pancreatectomy and 52 patients who underwent open pancreatectomy. Rates of receipt of adjuvant chemotherapy were 96.2% and 78.9%, respectively. Rate of early RIOT in the robotic group (73.1% was higher than that in the open group (44.2%; P = 0.018). In multivariable analysis, a robotic approach was associated with early RIOT (odds ratio, 3.54; 95% confidence interval 1.08–11.62; P = 0.038). Surgical approach did not impact late RIOT (odds ratio, 3.21; 95% confidence interval 0.71–14.38; P = 0.128). Conclusions: Compared with open pancreatectomy, robotic pancreatectomy did not delay RIOT. In fact, odds of early RIOT were increased, which supports the oncological safety of our robotic pancreatectomy program during its implementation.
- Subjects
SURGICAL robots; STATISTICAL models; EARLY medical intervention; PATIENT safety; PROBABILITY theory; FISHER exact test; KRUSKAL-Wallis Test; PATIENT readmissions; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; MULTIVARIATE analysis; PANCREATIC tumors; LONGITUDINAL method; PANCREATICODUODENECTOMY; ADJUVANT chemotherapy; ODDS ratio; PANCREATECTOMY; DUCTAL carcinoma; CONFIDENCE intervals; TREATMENT delay (Medicine); DATA analysis software; LENGTH of stay in hospitals; TIME
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2024, Vol 38, Issue 9, p4986
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-024-11022-3