Long-term outcomes of laparoscopic versus open D2 gastrectomy for advanced gastric cancer

Li, Zhengyan; Li, Bofei; Bai, Bin; Yu, Pengfei; Liu, Bo

doi:10.1016/j.suronc.2018.05.022

Cited by 25 publications

(29 citation statements)

References 37 publications

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“…The main end point of this study is PFS. According to literature, the 5-year PFS of the operation control group is about 45% [26][27][28]; we speculate that with the L-HIPEC + NAC intervention, the 5-year PFS can be increased to 60% (estimating a 15% increase). The random distribution ratio of the experimental group and the control group is 1:1, the test level α is set to 0.05 on both sides, the statistical test efficiency (power) is set to 80% (β = 0.2).…”

Section: Sample Size Calculationmentioning

confidence: 76%

Study protocol of a multicenter phase III randomized controlled trial investigating the efficiency of the combination of neoadjuvant chemotherapy (NAC) and neoadjuvant laparoscopic intraperitoneal hyperthermic chemotherapy (NLHIPEC) followed by R0 gastrectomy with intraoperative HIPEC for advanced gastric cancer (AGC): dragon II trial

Beeharry

Yang

et al. 2020

BMC Cancer

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Background: Even though treatment modalities such as adjuvant systemic radio-chemotherapy and neoadjuvant chemotherapy (NAC) have individually have improved overall survival (OS) and progression-free survival (PFS) rates in advanced Gastric Cancer (AGC), the peritoneum still presides as a common site of treatment failure and disease recurrence. The role of hyperthermic intraperitoneal chemotherapy (HIPEC) has been acknowledged as prophylaxis for peritoneal carcinomatosis (PC) in AGC patients and in this study, we aim at investigating the safety and efficacy of the combination of neoadjuvant laparoscopic HIPEC (NLHIPEC) with NAC in the neoadjuvant phase followed by surgery of curative intent with intraoperative HIPEC followed by adjuvant chemotherapy (AC).

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Section: Sample Size Calculationmentioning

confidence: 76%

Study protocol of a multicenter phase III randomized controlled trial investigating the efficiency of the combination of neoadjuvant chemotherapy (NAC) and neoadjuvant laparoscopic intraperitoneal hyperthermic chemotherapy (NLHIPEC) followed by R0 gastrectomy with intraoperative HIPEC for advanced gastric cancer (AGC): dragon II trial

Beeharry

Yang

et al. 2020

BMC Cancer

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“…Recently, many retrospective comparative studies and several prospective RCTs have reported that LG for AGC was safe and feasible when compared to the short-term and long-term outcomes observed with OG [2][3][4][5][6][7][8][9][10][11][12][13] . Table 1 summarizes these studies about LG for AGC in recent years.…”

Section: Previous Studies About Radical Lg For Agcmentioning

confidence: 99%

“…Table 1 summarizes these studies about LG for AGC in recent years. Propensity score matching analysis (PSM) was often used for comparison the LG and OG groups in some retrospective studies [8,10,12] . Especially, some authors demonstrated the technical safety of LDG with D2 LND for locally AGC in the multi-institutional, prospective, phase II study [2][3][4][5]11] .…”

Section: Previous Studies About Radical Lg For Agcmentioning

confidence: 99%

“…Especially, some authors demonstrated the technical safety of LDG with D2 LND for locally AGC in the multi-institutional, prospective, phase II study [2][3][4][5]11] . Moreover, the 3-year or 5-year overall or disease-free survival rates have been gradually reported from China, Korea, and Japan [7][8][9][10][11][12][13] . Majority of them reported that LG is feasible and safe for the treatment of AGC with D2 LND compared with OG, and no significant differences were observed in long-term over all survival (OS) and disease free survival (DFS) between the LG group and OG group.…”

Section: Previous Studies About Radical Lg For Agcmentioning

confidence: 99%

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Laparoscopic lymph nodes dissection for advanced gastric cancer: the current status and the perspective

Shimada¹,

Amaya²,

Munemoto³

et al. 2019

MIS

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The laparoscopic gastrectomy (LG) with D2 lymph node dissection (LND) for advanced gastric cancer (AGC) have been widely done. However, the applicability to more advanced disease is still under debate. Actually, there are a lot of technical demands against D2 LND for AGC, e.g., total omentectomy, splenic hilar node dissection, and the management for bulky lymph nodes, etc. Recently, extensive research has been gradually performed in the field of LG for AGC and demonstrated that LG for AGC is a safe and feasible procedure with better short-term outcomes compared with open gastrectomy. Also, large-scaled phase III trials are ongoing, and their long-term outcomes are awaited the publication in the near future. LG with D2 LND by expert surgeons under the cautious indications could be acceptable treatment for locally AGC. On the other hand, we should keep searching for solutions to the technical or oncological issues, and long-term outcome of phase III study should be warranted for standard treatment. Robotic surgery, LG following neoadjuvant chemotherapy, or conversion therapy using LG for several stage IV patients may help us clear the technical hurdles, and may show survival advantages in the future.

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“…Large propensity matched cohort studies have been performed to assess the long-term outcomes between OG and LG for advanced gastric cancer to achieve an immediate assessment whilst we await the results of RCTs. Li et al [22] matched 459 and 856 patients undergoing laparoscopic or OG (both distal and total) respectively for advanced gastric cancer with D2 lymph node resection. No significant difference was identified in the 5-year OS (52.0% and 53.4%; P = 0.805) and disease-free survival (46.8% vs. 47.3%; P = 0.963) between the laparoscopic and open groups.…”

Section: Long Term Oncological Outcomes and Morbiditymentioning

confidence: 99%

Gastrectomy: the expanding role of minimally invasive surgery in gastric cancer

Berg¹,

Shilton²,

Cheong³

2019

MIS

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Gastric cancer remains one of the most frequent cancers worldwide. Currently the only potentially curative treatment is surgery, often in combination with perioperative chemotherapy. Gastric cancer surgery is associated with significant morbidity. However, over the last few decades several potential advances have been introduced to improve the treatment for gastric cancer patients. Introduction of laparoscopic gastric cancer surgery has shown promising results and therefore gained popularity worldwide. This review describes an overview of laparoscopic gastrectomy for gastric cancer patients. In general, the introduction of laparoscopic surgery has shown improvement in the short-term outcomes of gastric cancer treatment. Laparoscopic approach for gastric cancer is feasible, safe and should be performed in experienced high volume centres. However, results from randomised trials in advanced gastric cancer are awaited to further determine the effect of a laparoscopic gastrectomy on oncological and longterm outcomes.

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Long-term outcomes of laparoscopic versus open D2 gastrectomy for advanced gastric cancer

Cited by 25 publications

References 37 publications

Laparoscopic lymph nodes dissection for advanced gastric cancer: the current status and the perspective

Gastrectomy: the expanding role of minimally invasive surgery in gastric cancer

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