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Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer: a large-scale multicenter retrospective study

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Author(s)
Do Joong ParkSang-Uk HanWoo Jin HyungMin Chan KimWook KimSeong Yeob RyuSeung-Wan RyuKyo Young SongHyuk-Joon LeeGyu-Seok ChoHyung-Ho KimKorean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group
Keimyung Author(s)
Ryu, Seung Wan
Department
Dept. of Surgery (외과학)
Journal Title
Surgical Endoscopy
Issued Date
2012
Volume
26
Issue
6
Keyword
Laparoscopy-assisted gastrectomyAdvanced gastric cancerLong-term survival
Abstract
Background Recently, the number of laparoscopic procedures
for gastric cancer has increased rapidly. Laparoscopic
surgery is reported to have many advantages over
open gastrectomy with oncologic safety in early gastric
cancer. However, there were few reports on long-term
outcomes of laparoscopy-assisted gastrectomy (LAG) for
advanced gastric cancer (AGC). The aim of this study was
to investigate long-term survival outcomes after LAG for
AGC.
Methods The data of 1,485 patients who underwent LAG
between April 1998 and December 2005 by ten surgeons at
ten hospitals were collected retrospectively. Among them,
239 patients who were diagnosed with AGC on final
pathologic examination were enrolled in the present study
to investigate long-term clinical outcomes.
Results The ratio of male to female patients was 151:88
and the mean age was 57.1 years. One hundred ninetythree
subtotal gastrectomies, 41 total gastrectomies, and 5
proximal gastrectomies were performed. D1 ? a, D1 ? b,
and D2 lymph node dissections were performed for 14, 62,
and 163 cases, respectively. The median follow-up period
was 55.4 months. The overall 5-year survival rate of the
239 AGC patients was 78.8% and the disease-specific
5-year survival rate was 85.6%. The 5-year survival rates
of the TNM staging system’s (7th ed.) stages were 90.5%
(stage Ib, n = 86), 86.4% (stage IIa, n = 53), 78.3% (stage
IIb, n = 44), 52.8% (stage IIIa, n = 24), 52.9% (stage IIIb,
n = 24), and 37.5% (stage IIIc, n = 8) (p\0.001).
Conclusion The long-term survival outcome rates of
LAG for AGC in the present study were comparable to
those previously reported for open gastrectomy. Based on the present results, a well-designed phase III trial comparing
LAG and open gastrectomy for AGC will be needed
to affirm the validity of LAG for AGC.
Keywords Laparoscopy-assisted gastrectomy
Advanced gastric cancer Long-term survival
Gastric cancer is one of the life-threatening cancers in the
world and is the most prevalent cancer in Korea. The most
important treatment for gastric cancer is surgery. The
definitive surgery for gastric cancer is subtotal or total gastrectomy
with D2 lymph node dissection. However, because
the incidence of early gastric cancer has increased due to a
national health screening program in Korea and Japan, the
concept of minimally invasive surgery such as endoscopic
submucosal dissection or laparoscopic gastrectomy was
introduced in the field of gastric cancer surgery [1]. Recently,
the number of laparoscopic procedures for gastric cancer has
increased rapidly [2]. Laparoscopic surgery is reported to
have many advantages over open gastrectomy, with oncologic
safety in early gastric cancer [3–8]. However, there
were few reports on long-term outcomes of laparoscopyassisted
gastrectomy (LAG) for advanced gastric cancer
(AGC) [9–11]. Therefore, we aimed to investigate the outcome
of LAG for AGC. This multicenter retrospective study
can be considered a basis for a prospective randomized
controlled trial (RCT) of LAG for AGC in the future.
Keimyung Author(s)(Kor)
류승완
Publisher
School of Medicine
Citation
Do Joong Park et al. (2012). Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer: a large-scale multicenter retrospective study. Surgical Endoscopy, 26(6), 1548–1553–1548–1553. doi: 10.1007/s00464-011-2065-7
Type
Article
ISSN
0930-2794
Source
https://link.springer.com/article/10.1007%2Fs00464-011-2065-7
DOI
10.1007/s00464-011-2065-7
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34443
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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