P1.071. Perioperative Patient-Reported Outcomes After Robot-Assisted Versus Conventional Minimally Invasive Esophagectomy for Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Analysis
TL;DR
Findings support RAMIE as a viable alternative with comparable patient-centered outcomes, though the higher anastomotic leak rate warrants further investigation.
Abstract
Esophageal Cancer: Surgical Treatment of Esophageal Cancer – technique Robot-assisted minimally invasive esophagectomy (RAMIE) is increasingly adopted, yet comparative patient-reported outcome (PRO) data against conventional minimally invasive esophagectomy (MIE) remains scarce. We aimed to compare perioperative PROs, including quality of life, nutritional status, cough-related quality of life, and anxiety, between RAMIE and MIE for esophageal squamous cell carcinoma (ESCC). We enrolled 214 patients with ESCC who underwent RAMIE (n = 47) or conventional MIE (n = 167) from an ongoing prospective cohort study. PROs were assessed using the EQ-5D-5L, PG-SGA, Leicester Cough Questionnaire (LCQ), and Self-rating Anxiety Scale (SAS). A 1:1 propensity score-matched (PSM) analysis was performed to balance baseline covariates. Nutritional trajectory was tracked from admission through discharge using serial PG-SGA assessments. Before PSM, the RAMIE group had significantly higher preoperative PG-SGA scores at admission (5.18 ± 3.32 vs 4.09 ± 3.01, P = 0.015) and pre-surgery (5.44 ± 3.69 vs 3.78 ± 2.88, P = 0.006), indicating worse baseline nutritional status. However, PG-SGA scores at discharge were comparable (4.56 ± 2.74 vs 4.42 ± 2.28, P = 0.931), demonstrating nutritional convergence. No significant differences were observed in EQ-5D-5L utility index (0.92 vs 0.93, P = 0.934), LCQ total score (121.6 vs 122.6, P = 0.751), or SAS standard score (45.4 vs 45.4, P = 0.551). The RAMIE group had a higher anastomotic leak rate (14.9% vs 4.8%, P = 0.025) but no Clavien-Dindo grade ≥III complications. RAMIE and conventional MIE achieved comparable perioperative PROs in ESCC patients. Despite worse baseline nutritional status in the RAMIE group, nutritional recovery by discharge was equivalent. These findings support RAMIE as a viable alternative with comparable patient-centered outcomes, though the higher anastomotic leak rate warrants further investigation.