Long-term outcomes of laparoscopic versus open D2 gastrectomy for advanced gastric cancer. (September 2018)

• Record Type: Journal Article
• Authors: Li, Zhengyan; Li, Bofei; Bai, Bin; Yu, Pengfei; Lian, Bo; Zhao, Qingchuan
• Is Part Of: Surgical oncology. Volume 27:Number 3(2018)
• Page Start: 441
• Page End: 448
• Publication Date: 2018-09
• Subjects: Laparoscopy -- Gastrectomy -- Gastric cancer -- Long-term outcome; Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2018.05.022
• Languages: English
• ISSNs: 0960-7404

Abstract

Abstract: Background: Technical safety and short-term surgical outcomes of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) have been investigated in many clinical trials. However, studies with large sample size and sufficient follow-up comparing LAG and open gastrectomy (OG) for AGC have seldom been reported. The purpose of this study was to compare the long-term outcomes of LAG versus open OG for AGC using a propensity score matching analysis. Methods: We retrospectively evaluated 459 and 856 patients who underwent LG or OG with D2 lymph node dissection, respectively, for AGC between June 2007 and June 2012. One-to-one propensity score matching was performed to compensate for heterogeneity between groups. We compared long-term outcomes between the two groups after propensity score matching. Results: In the propensity score-matched cohort, no significant differences were observed in 5-year overall survival (OS) (52.0% vs. 53.4%; P = 0.805) and disease-free survival (DFS) (46.8% vs. 47.3%; P = 0.963) between the LAG group and OG group. Stratified analysis showed that the 5-year OS and DFS rates were comparable between the two groups in each tumor stage (P > 0.05). Multivariate analysis revealed that the operation method was not an independent prognostic factor for OS or DFS. Further analysis showed that the recurrence pattern was similar between the LAG group the OG group (P > 0.05). Conclusion: LAG is a feasible surgical procedure for AGC in terms of long-term prognosis, although the results should be confirmed by the ongoing randomized controlled trials. Highlights: LAG and OG groups had similar results in terms of 5-year OS and DFS. LAG was not an independent prognostic factor for decreased OS or DFS. LAG is a feasible surgical procedure for AGC in comparison to OG in terms of long-term prognosis.