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

Abstract 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 CRP response and recurrence-free survival in RAS compared to LAS. Secondary endpoints included all-cause mortality and time-to-recurrence. Methods This Danish nationwide cohort study included patients diagnosed with 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 (Results A total of 3,484 patients were included in the study, with 490 (14.1%) undergoing RAS and 2,994 (85.9%) undergoing LAS. The median follow-up time was 32.5 months (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 Conclusion 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.