Robotic vs Laparoscopic and Open Surgery for Abdominopelvic Cancers

NCT07821775 | Completed

• 1 other identifier: AMC [2026-0316]
• Study Type: observational
• Target: 32,949
• Locations: 1 country
• Sites: 1

Brief Summary

Robotic surgery has become an increasingly common option for treating cancers in the abdomen and pelvis. However, whether robotic surgery leads to better cancer-related outcomes than laparoscopic (keyhole) surgery or open surgery is still uncertain. Results may differ across cancer types, and factors such as how complex the surgery is and how experienced the surgeon is may also influence the outcome. This retrospective cohort study examined adults who underwent curative-intent surgery for one of seven abdominopelvic cancers (pancreatic, gastric, rectal, cervical, endometrial, kidney, or prostate cancer) at a large tertiary hospital in Seoul, South Korea, between January 2012 and December 2021. Patients were classified into three groups according to the surgical approach they received: open, laparoscopic, or robotic surgery. The main outcome was 1-year disease-free survival, defined as the time from surgery to the first occurrence of cancer recurrence, distant metastasis, or death from any cause. Additional outcomes included 1-year mortality, overall mortality during follow-up, major postoperative complications, acute kidney injury, and length of hospital stay. To reduce differences between groups that might affect the comparison, the study used a statistical method called propensity score overlap weighting. Additional analyses adjusted for surgical complexity, surgeon experience including robotic learning curve, and pathological cancer stage to isolate the effect of the surgical platform itself. The purpose of this study was to evaluate whether the association between surgical approach and early oncologic and perioperative outcomes differed across the seven cancer types, and whether any observed advantage of the robotic platform remained after accounting for these factors.

Conditions

Pancreatic Neoplasms; Stomach Neoplasms; Kidney Neoplasms; Rectal Neoplasms; Prostatic Neoplasms; Uterine Cervical Neoplasms; Endometrial Neoplasms

Keywords

Robotic Surgery; Laparoscopic Surgery; Open Surgery; Oncologic Outcomes

Outcome Measures

Primary Outcomes (1)

• 1-Year Disease-Free Survival

  Time from surgery to the first occurrence of cancer recurrence, distant metastasis, or death from any cause, censored at 1 year. Recurrence and metastasis were confirmed radiologically or pathologically. Patients without an event were censored at the last postoperative surveillance encounter.

  1 year after surgery

Secondary Outcomes (5)

• 1-Year All-Cause Mortality

  1 year after surgery

• Overall All-Cause Mortality During Follow-up

  From date of surgery to date of death or end of follow-up, assessed up to approximately 10 years

• Major Postoperative Complications Within 30 Days

  Within 30 days after surgery

• Postoperative Acute Kidney Injury

  Within 7 days after surgery

• Hospital Length of Stay

  From date of surgery to date of hospital discharge, up to 90 days

Study Arms (3)

Open Surgery

Adults who underwent curative-intent abdominopelvic cancer surgery via open (laparotomy) approach for one of seven cancer types (pancreatic, gastric, rectal, cervical, endometrial, kidney, or prostate cancer) between January 2012 and December 2021.

Other: No Intervention: Observational Cohort

Laparoscopic Surgery

Adults who underwent curative-intent abdominopelvic cancer surgery via conventional laparoscopic approach for one of six cancer types (pancreatic, gastric, rectal, cervical, endometrial, or kidney cancer) between January 2012 and December 2021. Laparoscopic prostatectomy was not performed at the study institution during the study period.

Other: No Intervention: Observational Cohort

Robotic Surgery

Adults who underwent curative-intent abdominopelvic cancer surgery via robotic-assisted (da Vinci) approach for one of seven cancer types (pancreatic, gastric, rectal, cervical, endometrial, kidney, or prostate cancer) between January 2012 and December 2021.

Other: No Intervention: Observational Cohort

Interventions

No Intervention: Observational Cohort OTHER

Participants underwent curative-intent surgery for abdominopelvic malignancies (pancreatic, gastric, rectal, cervical, endometrial, kidney, or prostate cancer) and were followed retrospectively without any experimental intervention. The surgical approach (open, laparoscopic, or robotic) was determined by routine clinical practice, not by study protocol. Data were extracted from the institutional electronic medical record system and linked with national administrative data for outcome ascertainment.

Laparoscopic Surgery; Open Surgery; Robotic Surgery

Eligibility Criteria

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

Study Population

Adults aged 18 years or older who underwent curative-intent abdominopelvic surgery for one of seven nonmetastatic malignant solid tumors (pancreatic, gastric, rectal, cervical, endometrial, kidney, or prostate cancer) at Asan Medical Center, a large tertiary referral center in Seoul, Republic of Korea, between January 1, 2012, and December 31, 2021.

You may qualify if:

• Age 18 years or older
• Underwent curative-intent abdominopelvic surgery for a nonmetastatic malignant solid tumor of one of the following types: pancreatic, gastric, rectal, cervical, endometrial, kidney, or prostate cancer
• Surgery performed between January 1, 2012, and December 31, 2021
• Available postoperative surveillance data

You may not qualify if:

• Presence of distant metastasis before surgery
• Presentation with recurrent disease from previously treated cancer
• Incomplete or missing key demographic, comorbidity, operative, or outcome data required for analysis

Sponsors & Collaborators

• Asan Medical Center: lead

Study Sites (1)

Asan Medical Center, University of Ulsan College of Medicine

Seoul, Songpa-gu, 05505, South Korea

Location

MeSH Terms

Conditions

Pancreatic Neoplasms; Stomach Neoplasms; Rectal Neoplasms; Uterine Cervical Neoplasms; Endometrial Neoplasms; Kidney Neoplasms; Prostatic Neoplasms

Condition Hierarchy (Ancestors)

Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Endocrine Gland Neoplasms; Digestive System Diseases; Pancreatic Diseases; Endocrine System Diseases; Gastrointestinal Neoplasms; Gastrointestinal Diseases; Stomach Diseases; Colorectal Neoplasms; Intestinal Neoplasms; Intestinal Diseases; Rectal Diseases; Uterine Neoplasms; Genital Neoplasms, Female; Urogenital Neoplasms; Uterine Cervical Diseases; Uterine Diseases; Genital Diseases, Female; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Genital Diseases; Urologic Neoplasms; Kidney Diseases; Urologic Diseases; Male Urogenital Diseases; Genital Neoplasms, Male; Genital Diseases, Male; Prostatic Diseases

Study Officials

• Ji-Hoon Sim, MD, PhD

  Asan Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: September 10, 2026
• First Posted: September 16, 2026
• Study Start: January 1, 2012
• Primary Completion: December 31, 2022
• Study Completion: December 31, 2025
• Last Updated: September 16, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

KR (1)