Robotic versus open cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a propensity score-matched...

Area of Science:

• Oncology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is a standard treatment for peritoneal surface malignancies (PSM).
• Traditionally performed via laparotomy, the safety and efficacy of minimally invasive robotic approaches are not well-established.
• Limited data exist on robotic CRS/HIPEC outcomes for PSM.

Purpose of the Study:

• To evaluate the surgical safety and survival outcomes of robotic CRS/HIPEC compared to open CRS/HIPEC for PSM.
• To assess potential benefits of the robotic approach, such as reduced morbidity and hospital stay.

Main Methods:

• A single-center, propensity score-matched study (2018-2025) using prospectively collected data.
• 15 robotic CRS/HIPEC cases were matched 1:1 to 15 open CRS/HIPEC controls based on age, sex, BMI, histology, and Peritoneal Cancer Index (PCI).
• Surgical safety (major complications, reoperation, mortality) and survival (overall survival, progression-free survival) were compared.

Main Results:

• The robotic group showed significantly lower median blood loss (100 mL vs 250 mL) and shorter median hospital stay (6 vs 9 days).
• Complete tumor resection rates (CC-0/1) were high in both groups (100% robotic vs 93.3% open).
• No significant differences were observed in major complications, reoperations, 90-day mortality, overall survival, or progression-free survival.

Conclusions:

• Robotic CRS/HIPEC is a safe and feasible alternative to open surgery for PSM patients with low tumor burden.
• The robotic approach may offer advantages including reduced blood loss and shorter hospitalization.
• Further multicenter studies are needed to optimize patient selection and confirm these findings.