Potential Advantages of Robotic Total Gastrectomy in Advanced Middle-Upper Gastric Cancer: A Multicenter Propensity Score Matching Analysis

NCT06941168 | Completed DMC

• 1 other identifier: FJMU0416
• Study Type: observational
• Target: 1,099
• Locations: 1 country
• Sites: 1

Brief Summary

This multicenter retrospective cohort study aimed to evaluate the potential advantages of robotic total gastrectomy (RTG) compared to laparoscopic total gastrectomy (LTG) in patients with advanced middle and upper gastric cancer (AMUGC). A total of 1,099 patients who underwent radical total gastrectomy between 2013 and 2020 were included. After strict inclusion and exclusion criteria, propensity score matching (1:1) was conducted to balance baseline characteristics. The primary endpoint was 3-year disease-free survival (DFS), with secondary outcomes including overall survival, recurrence rates and patterns, and perioperative outcomes. All procedures were performed by experienced surgeons following standardized protocols across eight high-volume centers. Data quality was ensured through a centralized electronic system, unified training, and rigorous verification. This study provides real-world evidence on surgical outcomes and long-term prognosis, contributing to clinical decision-making in the treatment of AMUGC.

Conditions

Advanced Gastric Cancer

Keywords

Robotic surgery; advanced middle-upper gastric cancer; Total gastrectomy; Perioperative outcomes; Oncologic outcomes

Outcome Measures

Primary Outcomes (1)

• 3-year Disease-Free Survival (DFS)

  Disease-free survival was defined as the time between the date of surgery and date of the last follow-up for recurrence, death, or no recurrence

  3 years after surgery

Secondary Outcomes (3)

• 3-year overall survival (OS)

  3 years after surgery

• 3-year Cumulative Incidence of Recurrence (CIR)

  3 years after surgery

• Recurrence Patterns

  Up to 3 years after surgery

Study Arms (2)

RTG

Patients who underwent robotic total gastrectomy

Procedure: Robotic Total Gastrectomy and Laparoscopic Total Gastrectomy

LTG

Patients who underwent laparoscopic total gastrectomy

Procedure: Robotic Total Gastrectomy and Laparoscopic Total Gastrectomy

Interventions

Robotic Total Gastrectomy and Laparoscopic Total Gastrectomy PROCEDURE

RTG:Robotic total gastrectomy with D2 lymphadenectomy performed using the Da Vinci Surgical System, following the Japanese Gastric Cancer Treatment Guidelines. LTG:Laparoscopic total gastrectomy with D2 lymphadenectomy performed by experienced surgeons following standardized procedures, based on the Japanese Gastric Cancer Treatment Guidelines.

Also known as: RTG and LTG

LTG; RTG

Eligibility Criteria

• Age: 20 Years - 85 Years
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients diagnosed with middle or upper gastric cancer who underwent radical total gastrectomy at one of eight high-volume surgical centers in China between 2015 and 2019. Eligible patients had pathologically confirmed stage T2-4aNO-3bмоdisease, with no history of neoadjuvant therapy or other malignancies. All patients were treated according to standardized surgical and pathological protocols and had complete follow-up data for postoperative outcomes and survival analysis.

You may qualify if:

• \- Diagnosed with middle or upper gastric cancer (GC)
• Pathological stage T2-T4a, N0-N3b, M0 (postoperative)
• Underwent radical total gastrectomy

You may not qualify if:

• \- American Society of Anesthesiologists (ASA) class \> 3
• Residual gastric cancer
• Use of indocyanine green (ICG) during surgery
• Received neoadjuvant chemotherapy
• History of concurrent or previous malignancies
• Combined resection of other organs
• Lost to follow-up

Sponsors & Collaborators

• Fujian Medical University: lead

Study Sites (1)

Department of Gastric Surgery， Fujian Medical University Union Hospital

Fuzhou, Fujian, China

Location

MeSH Terms

Interventions

ezogabine

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: OTHER
• Target Duration: 3 Years
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Chief of Gastric Cancer Surgery

Study Record Dates

• First Submitted: April 16, 2025
• First Posted: April 23, 2025
• Study Start: January 1, 2015
• Primary Completion: June 1, 2019
• Study Completion: August 1, 2024
• Last Updated: April 23, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)