Surgical stress response and long-term survival in robot-assisted versus laparoscopic surgery for colon cancer: a propensity matched nationwide cohort study

Surgical stress response and long-term survival in robot-assisted versus laparoscopic surgery for colon cancer: a propensity matched nationwide cohort study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Surgical stress response and long-term survival in robot-assisted versus laparoscopic surgery for colon cancer: a propensity matched nationwide cohort study Pedja Cuk, Andreas Weinberger Rosen, Maliha Mashkoor, Mark Bremholm Ellebaek, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4271573/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose This study investigates the potential correlation between the surgical stress response and long-term survival in patients undergoing treatment for colon cancer using either RAS (robot-assisted surgery) or LAS (laparoscopic surgery), and whether this correlation is influenced by the surgical approach. The primary objective was to assess the association between postoperative CRP response and recurrence-free survival in RAS compared to LAS. Secondary endpoints included all-cause mortality and time-to-recurrence. Methods This Danish nationwide cohort study included patients diagnosed with UICC stage I-III colon cancer who underwent either RAS or LAS between 2010 and 2018. We employed the Cox proportional regression model to analyze the time-to-event outcomes for both primary and secondary endpoints in patients exhibiting either a low postoperative CRP response (< 80 mg/L) or a high CRP response (CRP ≥ 80 mg/L). Results A total of 3,484 patients were included in the study, with 490 (14.1%) undergoing RAS and 2,994 (85.9%) undergoing LAS. The median follow-up time was 32.5 months (IQR = 21.0-48.7) for the RAS group and 35.4 months (IQR = 22.8-50.9) for the LAS group. In the RAS group, a lower CRP response (CRP < 80 mg/L) was not associated with improved recurrence-free survival (HR = 0.78, 95% CI [0.53-1.13], p = 0.184), all-cause mortality (HR = 0.76, 95% CI [0.46-1.26], p = 0.282), or time-to-recurrence (HR = 0.64, 95% CI [0.49-1.06], p = 0.079). Conclusion The postoperative CRP response was not significantly associated with improved long-term survival outcomes in patients undergoing RAS or LAS for UICC stage I-III colon cancer. Surgical stress response robot-assisted surgery laparoscopic surgery minimally invasive surgery colon cancer long-term survival recurrence Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4271573","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":293128419,"identity":"60c112aa-9e7d-4450-acea-3897dfd2a56d","order_by":0,"name":"Pedja Cuk","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1klEQVRIiWNgGAWjYHACAwMQKcHeACTZGBhnEK+F5wAJWsCkhEQCkVrM2Zs3FPxgsEucOfPt4888ZQyyMxsIaLHsOVZg2MOQnDhbOt1Mmuccg/Fsgq66kWNgwMNwIHGedBobM28bQ+I8glruvzEw/APSInmM+TNxWm7wGBiDbJktwcYgDdJC0GGWPWkFxjIGycYze9LYJOeckzAm6H1z9sPbDN9U2MnOOH6M+cObMhvZGQcIOQwYFwbQqGFg4mGQIOQssBbmBzAO4w/CGkbBKBgFo2AEAgBSKTua2a4jjQAAAABJRU5ErkJggg==","orcid":"","institution":"University of Southern Denmark","correspondingAuthor":true,"prefix":"","firstName":"Pedja","middleName":"","lastName":"Cuk","suffix":""},{"id":293128420,"identity":"c9c24551-1972-46e9-b38b-f0338057ab87","order_by":1,"name":"Andreas Weinberger Rosen","email":"","orcid":"","institution":"Zealand University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Andreas","middleName":"Weinberger","lastName":"Rosen","suffix":""},{"id":293128421,"identity":"be57dafa-71b7-4729-bc64-52fef9f66c03","order_by":2,"name":"Maliha Mashkoor","email":"","orcid":"","institution":"Zealand University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Maliha","middleName":"","lastName":"Mashkoor","suffix":""},{"id":293128422,"identity":"b2ed89eb-e687-4599-9d2f-6fcb6b090716","order_by":3,"name":"Mark Bremholm Ellebaek","email":"","orcid":"","institution":"University of Southern Denmark","correspondingAuthor":false,"prefix":"","firstName":"Mark","middleName":"Bremholm","lastName":"Ellebaek","suffix":""},{"id":293128423,"identity":"85409bb2-4dff-49d8-8ce6-43da452aeee5","order_by":4,"name":"Ismail Gögenur","email":"","orcid":"","institution":"Zealand University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ismail","middleName":"","lastName":"Gögenur","suffix":""}],"badges":[],"createdAt":"2024-04-15 19:14:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4271573/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4271573/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":56646612,"identity":"50106f1a-299d-48ef-8ea4-5c319a9b8071","added_by":"auto","created_at":"2024-05-17 07:29:48","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":314744,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4271573/v1_covered_eb1b4305-f8ce-4c91-89f8-2c72f45689ab.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Surgical stress response and long-term survival in robot-assisted versus laparoscopic surgery for colon cancer: a propensity matched nationwide cohort study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Surgical stress response, robot-assisted surgery, laparoscopic surgery, minimally invasive surgery, colon cancer, long-term survival, recurrence","lastPublishedDoi":"10.21203/rs.3.rs-4271573/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4271573/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study investigates the potential correlation between the surgical stress response and long-term survival in patients undergoing treatment for colon cancer using either RAS (robot-assisted surgery) or LAS (laparoscopic surgery), and whether this correlation is influenced by the surgical approach. The primary objective was to assess the association between postoperative CRP response and recurrence-free survival in RAS compared to LAS. Secondary endpoints included all-cause mortality and time-to-recurrence.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis Danish nationwide cohort study included patients diagnosed with UICC stage I-III colon cancer who underwent either RAS or LAS between 2010 and 2018. We employed the Cox proportional regression model to analyze the time-to-event outcomes for both primary and secondary endpoints in patients exhibiting either a low postoperative CRP response (\u0026lt; 80 mg/L) or a high CRP response (CRP ≥ 80 mg/L).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 3,484 patients were included in the study, with 490 (14.1%) undergoing RAS and 2,994 (85.9%) undergoing LAS. The median follow-up time was 32.5 months (IQR = 21.0-48.7) for the RAS group and 35.4 months (IQR = 22.8-50.9) for the LAS group. In the RAS group, a lower CRP response (CRP \u0026lt; 80 mg/L) was not associated with improved recurrence-free survival (HR = 0.78, 95% CI [0.53-1.13], p = 0.184), all-cause mortality (HR = 0.76, 95% CI [0.46-1.26], p = 0.282), or time-to-recurrence (HR = 0.64, 95% CI [0.49-1.06], p = 0.079).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe postoperative CRP response was not significantly associated with improved long-term survival outcomes in patients undergoing RAS or LAS for UICC stage I-III colon cancer.\u003c/p\u003e","manuscriptTitle":"Surgical stress response and long-term survival in robot-assisted versus laparoscopic surgery for colon cancer: a propensity matched nationwide cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-23 09:26:12","doi":"10.21203/rs.3.rs-4271573/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b9f44b0b-d50b-4577-b067-292cdb45c2f0","owner":[],"postedDate":"April 23rd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-05-17T07:21:37+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-23 09:26:12","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4271573","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4271573","identity":"rs-4271573","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}