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Peer-reviewedCC BY-NCAnnals of coloproctology

Oncological outcomes of robotic versus laparoscopic colectomy for colon cancer: a propensity score-matched study focusing on peritoneal recurrence.

  • Takashi Nonaka1,2,3
  • Keisuke Noda1,2
  • Tetsuro Tominaga1,2
  • Hiroki Katayama1,2
  • Shintaro Hashimoto1,2
  • Makoto Hisanaga4
  • Hiroaki Takeshita5
  • Kazuo To6
  • Hidetoshi Fukuoka7
  • Keitaro Matsumoto1
7 affiliations
  1. 1Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
  2. 2Division of Colorectal Surgery, Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan
  3. 3Minimally Invasive Surgery Center, Nagasaki University Hospital, Nagasaki, Japan
  4. 4Department of Surgery, Sasebo City General Hospital, Nagasaki, Japan
  5. 5Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
  6. 6Department of Surgery, Ureshino Medical Center, Ureshino, Japan
  7. 7Department of Surgery, Isahaya General Hospital, Nagasaki, Japan
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Abstract

Purpose

To compare perioperative and oncologic outcomes between robotic and laparoscopic colectomy for colon cancer, with a focus on peritoneal recurrence, using a propensity score-matched analysis.Methods

We retrospectively reviewed 591 patients who underwent minimally invasive colectomy for colon cancer between 2016 and 2024. After 1:1 propensity score matching based on age, sex, body mass index, American Society of Anesthesiologists physical status, clinical stage, and procedure, 90 patients in each group were analyzed. Survival outcomes were assessed using Kaplan-Meier methods and competing risk analysis with the Fine-Gray model.Results

Robotic colectomy showed lower blood loss (median, 10 mL vs. 20 mL; P<0.001), shorter postoperative hospital stay (median, 9 days vs. 11.5 days, P<0.001), and a higher rate of intracorporeal anastomosis (92.2% vs. 24.4%, P<0.001), without prolonging operative time. Disease-free survival was comparable (P=0.519). Locoregional/peritoneal recurrence-free survival was higher in the robotic group (P=0.037); however, competing risk analysis using the Fine-Gray model showed no significant difference in the cumulative incidence of locoregional/peritoneal recurrence between groups. Multivariable analysis identified high-grade histology as an independent predictor of peritoneal recurrence, whereas surgical approach was not.Conclusion

Robotic colectomy provides favorable perioperative outcomes while maintaining oncologic safety comparable to laparoscopic colectomy. Peritoneal recurrence appears to be driven primarily by tumor biology, and intracorporeal anastomosis does not increase recurrence risk.

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Cite

BibTeXRIS
BibTeX
@article{nonaka2026oncological,
  title = {{Oncological outcomes of robotic versus laparoscopic colectomy for colon cancer: a propensity score-matched study focusing on peritoneal recurrence.}},
  author = {Takashi Nonaka and Keisuke Noda and Tetsuro Tominaga and Hiroki Katayama and Shintaro Hashimoto and Makoto Hisanaga and Hiroaki Takeshita and Kazuo To and Hidetoshi Fukuoka and Keitaro Matsumoto},
  journal = {Annals of coloproctology},
  year = {2026},
  month = oct,
  doi = {10.3393/ac.2026.00213.0030},
  url = {https://europepmc.org/article/MED/42958780},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Oncological outcomes of robotic versus laparoscopic colectomy for colon cancer: a propensity score-matched study focusing on peritoneal recurrence.
AU  - Takashi Nonaka
AU  - Keisuke Noda
AU  - Tetsuro Tominaga
AU  - Hiroki Katayama
AU  - Shintaro Hashimoto
AU  - Makoto Hisanaga
AU  - Hiroaki Takeshita
AU  - Kazuo To
AU  - Hidetoshi Fukuoka
AU  - Keitaro Matsumoto
PY  - 2026
DA  - 2026/10/01
JO  - Annals of coloproctology
DO  - 10.3393/ac.2026.00213.0030
UR  - https://europepmc.org/article/MED/42958780
AB  - Purpose  To compare perioperative and oncologic outcomes between robotic and laparoscopic colectomy for colon cancer, with a focus on peritoneal recurrence, using a propensity score-matched analysis.Methods  We retrospectively reviewed 591 patients who underwent minimally invasive colectomy for colon cancer between 2016 and 2024. After 1:1 propensity score matching based on age, sex, body mass index, American Society of Anesthesiologists physical status, clinical stage, and procedure, 90 patients in each group were analyzed. Survival outcomes were assessed using Kaplan-Meier methods and competing risk analysis with the Fine-Gray model.Results  Robotic colectomy showed lower blood loss (median, 10 mL vs. 20 mL; P<0.001), shorter postoperative hospital stay (median, 9 days vs. 11.5 days, P<0.001), and a higher rate of intracorporeal anastomosis (92.2% vs. 24.4%, P<0.001), without prolonging operative time. Disease-free survival was comparable (P=0.519). Locoregional/peritoneal recurrence-free survival was higher in the robotic group (P=0.037); however, competing risk analysis using the Fine-Gray model showed no significant difference in the cumulative incidence of locoregional/peritoneal recurrence between groups. Multivariable analysis identified high-grade histology as an independent predictor of peritoneal recurrence, whereas surgical approach was not.Conclusion  Robotic colectomy provides favorable perioperative outcomes while maintaining oncologic safety comparable to laparoscopic colectomy. Peritoneal recurrence appears to be driven primarily by tumor biology, and intracorporeal anastomosis does not increase recurrence risk.
SN  - 2287-9714
SN  - 2287-9722
ER  -