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Recurrence Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Multicenter Retrospective Analysis of 1,417 Patients

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Author(s)
류승완
Alternative Author(s)
Ryu, Seung Wan
Publication Year
2010
Abstract
Background. The risk of recurrence and recurrence patterns
after laparoscopy-assisted gastrectomy for gastric
cancer remain unclear. The objective of this study is to
assess recurrence and its timing, patterns, and risk factors
following laparoscopy-assisted gastrectomy from multicenter
data.
Methods. A retrospective multicenter study was performed
using data from 1,485 patients who had undergone
laparoscopy-assisted gastrectomy for gastric cancer at ten
institutions from 1998 to 2005. Recurrence and its timing
and patterns were reviewed. Univariate and multivariate
analyses were performed to identify risk factors for
recurrence.
Results. Excluding 68 patients (9 postoperative mortalities,
1 synchronous distant metastasis, 2 nonadenocarcinomas,
and 56 losses to follow-up), 50 of 1,417 patients (3.5%) had
recurrences. Incidence of recurrence was 1.6% (19/1186) in
early gastric cancer and 13.4% (31/231) in advanced gastric
cancer. Recurrence occurred in 34 of 50 patients (68.0%)
within 2 years of surgery, and in 45 of 50 patients (90.0%)
within 3 years. The recurrence pattern was hematogenous in
17 patients (34.0%), peritoneal in 11 (22.0%), locoregional
in 10 (20.0%), distant lymph nodes in 2 (4.0%), and mixed in
10 (20.0%). Advanced T-classification and lymph node
metastases were risk factors for recurrence.
Conclusions. Laparoscopy-assisted gastrectomy showed
satisfactory long-term oncologic outcomes similar to those
of open surgery. The study provides additional evidence
suggesting that laparoscopy-assisted gastrectomy is a good
alternative to open gastrectomy in patients with gastric
cancer of relatively early stage, although results of a randomized
controlled trial and more long-term follow-up are
needed to provide conclusive evidence.
Department
Dept. of Surgery (외과학)
Publisher
School of Medicine
Citation
Annals of Surgical Oncology, Vol.17(7) : 1777-1786, 2010
Type
Article
ISSN
1068-9265
DOI
10.1245/s10434-010-0932-4
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/35042
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