ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2025
Improved 5-year survival with robot-assisted resection for locally advanced rectal cancer compared to laparoscopic and open surgery: A real-world cohort study.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Gender-Specific Cancer-Related Survival Analysis of Robotic Versus Laparoscopic Low Anterior Resection for Rectal Adenocarcinoma: A Multicenter Study.The international journal of medical robotics + computer assisted surgery : MRCAS · 2026Observational
- Robot-assisted colectomy is associated with improved perioperative outcomes and favorable survival in stage I-III colon cancer: a nationwide overlap-weighted analysis.Surgical endoscopy · 2026Article
- Essential Updates 2024-2026: Advances in Colorectal Cancer Surgery.Annals of gastroenterological surgery · 2026Review
- Robotic surgery for rectal cancer in 2026: a hierarchical appraisal of the evidence.Journal of robotic surgery · 2026Review
- Low anterior resection syndrome after rectal cancer surgery: mechanisms, assessment, management, and the potential role of robotic surgery.Frontiers in oncology · 2026Review
- Improved 5-year survival with robot-assisted resection for locally advanced rectal cancer compared to laparoscopic and open surgery: A real-world cohort study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
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Abstract
aimRobot-assisted rectal cancer surgery offers short-term benefits; however, data on its long-term outcomes are lacking. In this study, we aimed to compare the short- and long-term outcomes of open, laparoscopic and robot-assisted rectal resection (ORR, LRR and RARR) for locally advanced rectal cancer using a large real-world database.
methodsThis multi-centre retrospective cohort study analysed 37,191 patients with clinical T3/T4a rectal cancer from the Japanese Medical Data Vision database (2018-2024). After overlap weighting for baseline balance, the effective sample size was 14,627. The primary outcomes were 5-year overall survival (OS) and relapse-free survival (RFS). The secondary outcomes included peri-operative outcomes.
resultsAfter overlap weighting, the total number of patients was 2247, 10,339 and 2041 in the RARR, LRR and ORR groups, respectively. The mean age was 70 years, and 66% were male. The RARR group had the lowest post-operative complication rate (17%), shortest duration of hospital stay (16 days) and lowest 90-day mortality rate and total hospitalisation cost; and the highest 5-year OS (94%) and 5-year RFS (93%) compared with the LRR (5-year OS: 86%, 5-year RFS: 83%; p < 0.001) and ORR (5-year OS: 78%, 5-year RFS: 74%; p < 0.001) groups. RARR was significantly associated with improved OS, whereas higher risks were observed for LRR (hazard ratio [HR]: 2.50) and ORR (HR: 4.69).
conclusionRobot-assisted surgery demonstrated superior short- and long-term outcomes and the lowest total hospitalisation cost compared with other approaches. These results demonstrate the potential of robot-assisted surgery as a new standard of treatment for locally advanced rectal cancer.
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