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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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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 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).

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.

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Acknowledgment

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).

Disclosure

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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Authors and Affiliations

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

    Do Joong Park & Hyung-Ho Kim

  2. Department of Surgery, Ajou University College of Medicine, Suwon, Korea

    Sang-Uk Han

  3. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

    Woo Jin Hyung

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

    Min Chan Kim

  5. Department of Surgery, Holy Family Hospital, Catholic University of Korea, Bucheon, Korea

    Wook Kim

  6. Department of Surgery, Chonnam National University School of Medicine, Gwangju, Korea

    Seong Yeob Ryu

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

    Seung-Wan Ryu

  8. Department of Surgery, Kangnam St. Mary’s Hospital, Catholic University of Korea, Seoul, Korea

    Kyo Young Song

  9. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

    Hyuk-Joon Lee & Hyung-Ho Kim

  10. Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea

    Gyu-Seok Cho

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  1. Do Joong Park
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Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group

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Correspondence to Hyung-Ho Kim.

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Park, D.J., Han, SU., Hyung, W.J. et al. Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer: a large-scale multicenter retrospective study. Surg Endosc 26, 1548–1553 (2012). https://doi.org/10.1007/s00464-011-2065-7

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  • DOI: https://doi.org/10.1007/s00464-011-2065-7

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