P1.185. Health-Related Quality of Life After Robot-Assisted Versus Thoracoscopic Esophagectomy: A Secondary Analysis From the Multicenter RAMIE Trial

Abstract

Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer Background The comparative effects of robot-assisted and thoracoscopic esophagectomy on postoperative health-related quality of life (HRQOL) are not well defined. Here, we sought to assess patient-reported HRQOL outcome following robot-assisted versus thoracoscopic esophagectomy in patients with esophageal squamous cell carcinoma (ESCC). Methods This prespecified secondary analysis utilized data from the multicenter, randomized RAMIE trial (NCT03094351), including patients with ESCC who underwent curative McKeown esophagectomy. Participants were randomly assigned to receive either robot-assisted or thoracoscopic esophagectomy were monitored prospectively for HRQOL outcomes using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-OES18 questionnaires administered at baseline and at 1, 3, and 12 months postoperatively. Longitudinal patterns were examined using generalized estimating equations. Results The per-protocol analysis included 358 patients (robot-assisted group, n = 181; thoracoscopic group, n = 177). Following esophagectomy, robot-assisted surgery showed improved efficiency of thoracic lymph node dissection in patients who received neoadjuvant therapy (15 vs 12, P = 0.016), as well as higher achievement rate of lymph node dissection along the left recurrent laryngeal nerve (79.5% vs 67.6%, P = 0.001). Overall, both cohorts showed a temporary decline in several HRQOL domains. The mean scores for global health status at baseline and at 1, 3, and 12 months postoperatively were comparable. Regarding the variable of “trouble talking”, both groups exhibited moderate worsening at 1 month postoperatively and returned to baseline levels at 3 months. Each functional and symptom scale in the QLQ-C30 and QLQ-OES18 questionnaires demonstrated no significant difference over time between the two groups. Conclusion There were no clear HRQOL benefits of robot-assisted over thoracoscopic esophagectomy. However, robot-assisted esophagectomy conferred several perioperative benefits.