Minimally invasive lymphadenectomy for gastric cancer: Could the robotic approach provide any benefits than laparoscopy?

Table 2 Summarized characteristics of Western published randomized control trials

Trial	Ref.	Country	Study period	Patients	Patients/center per year	Study design	Approach (n)			Surgery (n)		Neo adjuvant (%)	Pathological T (n)					D2 (%)1	Primary outcomes	Main results
							Open	Laparoscopic	Robotic	Distal	Total		1	2	3	4	x
Huscher	Huscher et al[94], 2005	Italy	1998 to 2001	59	24.5	cT1-4 N0-2	29	30	0	59	0	0	13	15	21	10	0	69.5	Short-term surgical outcome, 5-year overall and disease-free survival	Laparoscopic group had similar mean number of harvested lymph nodes (33.4 vs 30; P > 0.05) and operative mortality (27.6% vs 26.7%; P > 0.05) than open. Five-year overall and disease-free survival rates were similar between groups; P > 0.05
STOMACH	van der Wielen et al[23], 2021	European Union	2015 to 2018	96	2	cT1-4a N0-3	49	47	0	0	96	100	142	9	36	27	0	42.7	Oncological safety, measured as the number of resected lymph nodes and radicality	Mean number of resected lymph nodes was 43.4 ± 17.3 in open and 41.7 ± 16.1 in minimally invasive group (P = 0.612) after neoadjuvant. No significant differences in R0 resection between laparoscopic (98%) and open groups (93.6%); P = 0.617
LOGICA	van der Veen et al[22], 2021	Netherland	2015 to 2018	215	6.5	cT1-4a N0-3	105	110	0	123	92	72.2	292	26	89	55	0	99.5	Hospital stay	Median hospital stay was 7 days (interquartile range, 5-9) in both groups; P = 5.34
Ribeiro	Ribeiro et al[72], 2022	Brazil	2015 to 2020	60	12.5	cT1-4a N0-1	31	0	29	51	9	0	26	12	11	11	0	100	Short-term surgical outcome	Robotic group had similar mean number of harvested lymph nodes (41.3 vs 42.4; P = 0.805), longer surgical time (354 vs 215 minutes; P < 0.001), and less bleeding (124 vs 276 mL; P < 0.001) compared to open

¹D2 lymphadenectomy according to Japanese gastric cancer treatment guidelines.

²Remnant patients resulted ypT0 or ypTis.