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Purpose <p>This 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.</p> Methods <p>This 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 (&lt; 80&#xa0;mg/L) or a high CRP response (CRP ≥ 80&#xa0;mg/L).</p> Results <p>A 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&#xa0;months (interquartile range [IQR] = 21.0–48.7) for the RAS group and 35.4&#xa0;months (IQR = 22.8–50.9) for the LAS group. In the RAS group, a lower CRP response (CRP &lt; 80&#xa0;mg/L) was not associated with improved recurrence-free survival (HR = 0.78, 95% confidence interval [CI] [0.53–1.13], <i>p</i> = 0.184), all-cause mortality (hazard ratio [HR] = 0.76, 95% CI [0.46–1.26], <i>p</i> = 0.282), or time-to-recurrence (HR = 0.64, 95% CI [0.49–1.06], <i>p</i> = 0.079).</p> Conclusions <p>The 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.</p>

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Surgical stress response and long-term survival in robot-assisted versus laparoscopic surgery for colon cancer: a propensity matched nationwide cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月18日

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  • Pedja Cuk,
  • A. W. Rosen,
  • M. Mashkoor,
  • M. B. Ellebæk,
  • I. Gögenur

摘要

Purpose

This 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.

Methods

This 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).

Results

A 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).

Conclusions

The 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.