Comparing the initiation of adjuvant chemotherapy after robotic and laparoscopic colon cancer surgeries: A case-controlled study with propensity score matching

PURPOSE: Early initiation of adjuvant chemotherapy after colon cancer surgery has shown better oncologic outcomes in previous studies. However, the clinical impact of robotic and laparoscopic surgeries on the initiation of adjuvant chemotherapy has not been widely evaluated. Hence, the study’s aim was to compare the influence of both surgical approaches on the initiation of adjuvant chemotherapy after colon cancer surgery. METHODS: From June 2011 to September 2017, 289 patients underwent curative robotic or laparoscopic surgery followed by adjuvant chemotherapy for stage II and III colon cancer. To control for different demographic factors in the two groups, propensity score case matching was used at a 1:4 ratio. Finally, 190 patients were matched with 38 patients of the robotic surgery group and 152 patients of the laparoscopic surgery group. RESULTS: The operation time was longer in the robotic surgery group (297 minutes vs. 170 minutes, respectively; P<0.001). However, conversion rate, number of retrieved lymph nodes, first flatus, first soft diet, length of stay, postoperative complication rate, and Clavien-Dindo grade were not significantly different between the two groups. Additionally, there was no difference in the time to initiation of adjuvant chemotherapy between the two groups (31.5 days vs. 29.0 days, respectively; P=0.226). Disease-free and overall survival rates were also not significantly different. CONCLUSION: Robotic and laparoscopic surgeries showed no different impact on the initiation of adjuvant chemotherapy. This finding suggests that the two surgical approaches offer similar postoperative outcomes.