Risk of recurrence after laparoscopy-assisted radical gastrectomy for gastric cancer performed by a single surgeon
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The risk of recurrence after laparoscopy-assisted radical gastrectomy (LAG) was investigated.
Materials and methods
Clinical data of 398 consecutive patients who underwent radical gastrectomy with R0 resection for gastric cancer at Gyeongsang National University Hospital between January 2005 and December 2007 were reviewed retrospectively.
Of the patients, 65.4% (n = 261) and 34.6% (n = 138) underwent LAG and open radical gastrectomy (OG), respectively. Of the LAG cases, 73.2% (n = 192), 10.7% (n = 28), 12.6% (n = 33), and 3.1% (n = 8) had stage I, II, III, and IV gastric cancer, respectively. All patients were followed up for a mean of 36.8 ± 13.7 months, and 14.6% (n = 58) had recurrence during the follow-up period. Univariate analysis revealed that tumor size, tumor–node–metastasis (TNM) stage, method of approach (LAG versus OG), and operation type were associated significantly with recurrence. Multivariate analysis revealed that only high TNM stage was significantly associated with recurrence (P = 0.00). While patients who underwent OG had higher incidence of recurrence than patients who underwent LAG, OG was not significantly associated with recurrence on multivariate analysis (P = 0.06).
LAG and OG did not differ significantly in terms of recurrence, even when used in advanced gastric cancer cases. Multivariate analysis revealed that high TNM stage was significantly associated with recurrence. Thus, LAG appears to be a safe and feasible procedure that has the potential to be an alternative to open surgery, even for advanced gastric cancer.
KeywordsStomach neoplasm Recurrence Laparoscopy Laparoscopic gastrectomy Laparoscopy-assisted gastrectomy
The authors would like to thank Young-Suk Kim RN and Mi-Hee Jung AN for conducting telephone interviews.
Authors Sang-Ho Jeong, Young-Joon Lee, Soon-Tae Park, Sang-Kyung Choi, Soon-Chan Hong, Eun-Jung Jung, Young-tae Joo, Chi-Young Jeong, and Woo-Song Ha have no conflicts of interest or financial ties to disclose.
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