Surgical Endoscopy

, Volume 26, Issue 6, pp 1548–1553 | Cite as

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

  • Do Joong Park
  • Sang-Uk Han
  • Woo Jin Hyung
  • Min Chan Kim
  • Wook Kim
  • Seong Yeob Ryu
  • Seung-Wan Ryu
  • Kyo Young Song
  • Hyuk-Joon Lee
  • Gyu-Seok Cho
  • Hyung-Ho Kim
  • Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group



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.


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.


The ratio of male to female patients was 151:88 and the mean age was 57.1 years. One hundred ninety-three subtotal gastrectomies, 41 total gastrectomies, and 5 proximal gastrectomies were performed. D1 + α, D1 + β, 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).


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.


Laparoscopy-assisted gastrectomy Advanced gastric cancer Long-term survival 



This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (grant No. 0520310).


Drs. Do Joong Park, Sang-Uk Han, Woo Jin Hyung, Min Chan Kim, Wook Kim, Seong Yeob Ryu, Seung-Wan Ryu, Kyo Young Song, Hyuk-Joon Lee, Gyu-Seok Cho, and Hyung-Ho Kim have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Do Joong Park
    • 1
  • Sang-Uk Han
    • 2
  • Woo Jin Hyung
    • 3
  • Min Chan Kim
    • 4
  • Wook Kim
    • 5
  • Seong Yeob Ryu
    • 6
  • Seung-Wan Ryu
    • 7
  • Kyo Young Song
    • 8
  • Hyuk-Joon Lee
    • 9
  • Gyu-Seok Cho
    • 10
  • Hyung-Ho Kim
    • 1
    • 9
  • Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group
  1. 1.Department of Surgery, Seoul National University College of MedicineSeoul National University Bundang HospitalSeongnam-siKorea
  2. 2.Department of SurgeryAjou University College of MedicineSuwonKorea
  3. 3.Department of SurgeryYonsei University College of MedicineSeoulKorea
  4. 4.Department of SurgeryDong-A University College of MedicineBusanKorea
  5. 5.Department of Surgery, Holy Family HospitalCatholic University of KoreaBucheonKorea
  6. 6.Department of SurgeryChonnam National University School of MedicineGwangjuKorea
  7. 7.Department of SurgeryKeimyung University School of MedicineDaeguKorea
  8. 8.Department of Surgery, Kangnam St. Mary’s HospitalCatholic University of KoreaSeoulKorea
  9. 9.Department of SurgerySeoul National University College of MedicineSeoulKorea
  10. 10.Department of SurgerySoonchunhyang University College of MedicineSeoulKorea

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