ArticleTechniques in coloproctology2025
Surgical stress response and long-term survival in robot-assisted versus laparoscopic surgery for colon cancer: a propensity matched nationwide cohort study.
Article in Techniques in coloproctology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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5 authors.
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Abstract
purposeThis study investigates the potential correlation between the surgical stress response and long-term survival in patients undergoing treatment for colon cancer using either RAS (robot-assisted surgery) or LAS (laparoscopic surgery) and whether this correlation is influenced by the surgical approach. The primary objective was to assess the association between postoperative C-reactive protein (CRP) response and recurrence-free survival in RAS compared with LAS. Secondary endpoints included all-cause mortality and time-to-recurrence.
methodsThis Danish nationwide cohort study included patients diagnosed with Union for International Cancer Control (UICC) stage I-III colon cancer who underwent either RAS or LAS between 2010 and 2018. We employed the Cox proportional regression model to analyze the time-to-event outcomes for both primary and secondary endpoints in patients exhibiting either a low postoperative CRP response (< 80 mg/L) or a high CRP response (CRP ≥ 80 mg/L).
resultsA total of 3484 patients were included in the study, with 490 (14.1%) undergoing RAS and 2994 (85.9%) undergoing LAS. The median follow-up time was 32.5 months (interquartile range [IQR] = 21.0-48.7) for the RAS group and 35.4 months (IQR = 22.8-50.9) for the LAS group. In the RAS group, a lower CRP response (CRP < 80 mg/L) was not associated with improved recurrence-free survival (HR = 0.78, 95% confidence interval [CI] [0.53-1.13], p = 0.184), all-cause mortality (hazard ratio [HR] = 0.76, 95% CI [0.46-1.26], p = 0.282), or time-to-recurrence (HR = 0.64, 95% CI [0.49-1.06], p = 0.079).
conclusionsThe postoperative CRP response was not significantly associated with improved long-term survival outcomes in patients undergoing RAS or LAS for UICC stage I-III colon cancer.
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