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Long-term outcome after laparoscopic gastrectomy: a multicenter retrospective study

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Abstract

Background

Despite its spread and advances, laparoscopic gastrectomy (LG) for advanced gastric cancer (AGC) remains controversial. The aim of this study was to evaluate the oncologic outcomes and to identify the potential risk factors for recurrence and survival after LG in AGC patients.

Patients and methods

The medical records of patients who underwent radical LG for histopathologically diagnosed stage IB or more advanced gastric cancer from 2004 to 2012 were collected. The clinicopathologic factors and outcomes were evaluated retrospectively.

Results

LG was performed for 300 patients, with a median operative time of 278 min and blood loss of 46 ml. Postoperative morbidity was defined as Clavien-Dindo grades III and IV and occurred in 13 patients (6.3%) in the laparoscopic distal gastrectomy group. The pathologic stage was IB in 109 patients (36.3%), IIA in 77 patients (25.7%), IIB in 48 patients (16.0%), IIIA in 31 patients (10.3%), IIIB in 19 patients (6.3%), and IIIC in 16 patients (5.3%). Median follow-up period was 55.2 months. The 3-year relapse-free survival (RFS) rate was 92.7% for stage IB, 87.0% for IIA, 68.8% for IIB, 64.5% for IIIA, 47.4% for IIIB, and 43.8% for IIIC. The 5-year actual overall survival rate was 91.1% for stage IB, 72.7% for II, and 62.5% for III. Multivariate analysis revealed postoperative complication as an independent risk factor for RFS.

Conclusion

LG for AGC was feasible and provided comparable oncologic outcomes with those previously reported. Postoperative complications correlated with poor prognosis. Randomized control trials should be conducted to confirm these results of LG for AGC in the general population.

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Authors and Affiliations

  1. Department of Surgery, Sapporo Kiyota Hospital, Shinei 1-1-1-1, Kiyota-ku, Sapporo, Hokkaido, Japan

    Hiroshi Kawase

  2. Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, North-15, West-7, Kita-ku, Sapporo, Hokkaido, Japan

    Hiroshi Kawase, Yuma Ebihara, Toshiaki Shichinohe & Satoshi Hirano

  3. Department of Surgery, Teine Keijinkai Hospital, Maeda 1-12-1-40, Teine-ku, Sapporo, Hokkaido, Japan

    Fumitaka Nakamura

  4. Department of Surgery, Obihiro-Kosei General Hospital, West-6, South-8, Obihiro, Hokkaido, Japan

    Katsuhiko Murakawa

  5. Department of Surgery, Hokkaido Gastroenterology Hospital, Honcho 1-1, Higashi-ku, Sapporo, Hokkaido, Japan

    Takayuki Morita

  6. Department of Surgery, Tonan Hospital, North-1, West-6, Chuou-ku, Sapporo, Hokkaido, Japan

    Shunichi Okushiba

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  1. Hiroshi Kawase
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  2. Yuma Ebihara
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  4. Fumitaka Nakamura
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Corresponding author

Correspondence to Hiroshi Kawase.

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Ethical standards

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1964 and its later versions. Informed consent for study inclusion was obtained from all patients.

Conflicts of interest

The authors have no financial conflicts of interest to disclose concerning this research.

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Kawase, H., Ebihara, Y., Shichinohe, T. et al. Long-term outcome after laparoscopic gastrectomy: a multicenter retrospective study. Langenbecks Arch Surg 402, 41–47 (2017). https://doi.org/10.1007/s00423-017-1559-8

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  • DOI: https://doi.org/10.1007/s00423-017-1559-8

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