title: Robot-assisted surgery for gastric carcinoma: Five years follow-up and beyond: A single western center experience and long-term oncological outcomes.
abstract: BACKGROUND
  Robot-assisted surgery for the treatment of gastric cancer is considered to be safe and feasible with early post-operative outcomes comparable to open and laparoscopic series. However, data regarding long-term oncological outcomes are lacking. Aim of this study is to evaluate long-term oncological outcomes of a cohort of gastric cancer patients treated surgically with the robot-assisted approach.
  
  
  METHODS
  A prospectively collected database of robot-assisted gastrectomies performed for gastric cancer at the 'Misericordia Hospital' between September 2001 and October 2011 was retrospectively analysed. Data regarding surgical procedures, early postoperative course, and long-term follow-up were analysed.
  
  
  RESULTS
  The study included 98 consecutive robot-assisted gastrectomies. Fifty-nine distal gastrectomies, 38 total gastrectomies, and 1 proximal gastrectomy. Open conversion occurred in seven patients (7.1%) due to locally advanced disease. Postoperative morbidity and mortality were 12.2% and 4.1% respectively. Post-operative staging showed 46 patients (46.9%) with stage I disease, 25 patients (25.5%) with stage II, 26 (26.5%) with stage III and 1 (1.02%) with stage IV. The mean follow-up was 46.9 months. Cumulative 5-year overall survival (OS) was 73.3% (95% CI: 62.2-84.4). Five-year survival by stage subgroups was 100% for patients with stage IA, 84.6% for stage IB, 76.9% for stage II, and 21.5% for stage III. The only patient in stage IV of this series died eight months after surgery.
  
  
  CONCLUSIONS
  Robot-assisted gastrectomy for the treatment of gastric cancer is safe and feasible. It provides long-term outcomes comparable to most open and laparoscopic series. Further studies are necessary to better define its indication.
authors: Department of General Surgery, Misericordia Hospital, Grosseto, Italy.
authors: A
authors: A
authors: Coratti
authors: Kings College Hospital, London, UK. Electronic address: e.fernandes@mclink.it.
authors: E
authors: E
authors: Fernandes
authors: Department of General Surgery, Misericordia Hospital, Grosseto, Italy.
authors: A
authors: A
authors: Lombardi
authors: Department of General Surgery, Misericordia Hospital, Grosseto, Italy.
authors: M
authors: M
authors: Di Marino
authors: Department of General Surgery, Misericordia Hospital, Grosseto, Italy.
authors: M
authors: M
authors: Annecchiarico
authors: Department of General Surgery, Misericordia Hospital, Grosseto, Italy.
authors: L
authors: L
authors: Felicioni
authors: Department of Surgery, Division of General, Minimally Invasive, and Robotic Surgery, University of Illinois at Chicago, Chicago, IL, USA.
authors: P C
authors: PC
authors: Giulianotti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012371:Robotics / Q000379:methods*; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Gastrectomy; Gastric cancer; Robotic surgery; Survival