Minimally invasive surgical techniques for oncologic resections: A multi-specialty experience within a high-volume center

Background Minimally invasive surgery (MIS) is prevalent in surgical oncology. While some studies suggest that MIS is associated with perioperative benefits and comparable oncologic outcomes, more recent studies in robotic surgery dispute these findings. We aim to assess perioperative and oncologic outcomes with robotic, laparoscopic/ thoracoscopic, and open procedures across multiple surgical oncology specialties. Methods We performed a retrospective review of all patients ≥ 18 years of age, at Memorial Sloan Kettering Cancer Center (MSKCC), who underwent robotic, laparoscopic /thoracoscopic, and open procedures between January 2000 and December 2018. Patients with the following disease sites were included: lung, thymus, esophagus, stomach, colon, distal pancreas, renal, prostate, urothelial, cervical, and uterine. Analyses were conducted within each procedure separately. After propensity-score weighting, multivariable models including survey-weighted generalized linear regressions and Cox regressions quantified the association between surgical approach and outcomes. Results Compared to open surgery, robotic and laparoscopic surgeries were associated with shorter length of stay but longer operative times. Oncologic outcomes, including resection margins and number of nodes harvested, were comparable with MIS across most procedures. Recurrence-free survival and overall survival following MIS were comparable to those observed with other surgical approaches. Conclusion MIS, including robotic-assisted techniques, are associated with similar perioperative and oncologic outcomes compared to open surgery. Our findings support MIS as a safe and viable option for oncologic procedures.