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

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Department of Surgery, Insititute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

    Jyewon Song MD & Woo Jin Hyung MD

  2. Department of Surgery, Seoul National University, Seoul, Korea

    Hyuk-Joon Lee MD

  3. Department of Surgery, Soonchunhyang University School of Medicine, Gyeonggi-do, Korea

    Gyu Seok Cho MD

  4. Department of Surgery, Ajou University School of Medicine, Gyeonggi-do, Korea

    Sang-Uk Han MD

  5. Department of Surgery, Dong-A University College of Medicine, Busan, Korea

    Min-Chan Kim MD

  6. Department of Surgery, Keimyung University School of Medicine, Daegu, Korea

    Seung Wan Ryu MD

  7. Department of Surgery, The Catholic University of Korea, St. Mary’s Hospital, Seoul, Korea

    Wook Kim MD & Kyo Young Song MD

  8. Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea

    Hyung-Ho Kim MD

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  1. Jyewon Song MD
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  2. Hyuk-Joon Lee MD
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Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group

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Correspondence to Woo Jin Hyung MD.

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Song, J., Lee, HJ., Cho, G.S. et al. Recurrence Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Multicenter Retrospective Analysis of 1,417 Patients. Ann Surg Oncol 17, 1777–1786 (2010). https://doi.org/10.1245/s10434-010-0932-4

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  • DOI: https://doi.org/10.1245/s10434-010-0932-4

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