Long-Term Results of Laparoscopic Gastrectomy for Gastric Cancer: A Large-Scale Case-Control and Case-Matched Korean Multicenter Study

Kim, Hyung‐Ho; Han, Sang Uk; Kim, Min Chan; Hyung, Woo Jin; Kim, Wook; Lee, Hyuk Joon; Ryu, Seung Wan; Cho, Gyu Seok; Song, Kyo Young; Ryu, Seong Yeob

doi:10.1200/jco.2013.48.8551

Cited by 290 publications

(199 citation statements)

References 21 publications

Supporting

Mentioning

180

Contrasting

Order By: Relevance

“…The 5-year survival rate of 98.2% for both OS and RFS is comparable with that of previous retrospective studies assessing laparoscopic gastrectomy [10][11][12]. For open surgery, Nashimoto et al [13] Kim et al [12] reported the OS after matching for the operation method and surgeons did not show any significant differences between open gastrectomy and laparoscopic gastrectomy for all stages of cancer.…”

Section: Discussionsupporting

confidence: 72%

“…For open surgery, Nashimoto et al [13] Kim et al [12] reported the OS after matching for the operation method and surgeons did not show any significant differences between open gastrectomy and laparoscopic gastrectomy for all stages of cancer. A recent observational study of 1848 stage I gastric cancer patients adjusted the backgrounds using propensity matching with confounding factors to demonstrate favorable long-term survival of LADG patients compared with ODG patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)

et al. 2017

View full text Add to dashboard Cite

Background Laparoscopic gastrectomy has become a common surgical treatment for gastric cancer in eastern Asian countries. However, a large-scale prospective study to investigate the benefit of laparoscopy-assisted distal gastrectomy (LADG) regarding long-term outcomes has never been reported. We have already reported the shortterm outcomes of this study. Here we report long-term outcomes as the secondary endpoints of this study after a 5-year follow-up period. Methods This study comprised patients with clinical stage I gastric cancer who were able to undergo a distal gastrectomy. LADG with D1 plus suprapancreatic lymph node dissection was performed by credentialed gastric surgeons who had each conducted at least 30 LADG and 30 open gastrectomy procedures. The primary endpoint was the proportion of patients who developed either anastomotic leakage or pancreatic fistula. The secondary endpoints included overall survival and relapse-free survival. Results From November 2007 to September 2008, 176 eligible patients were enrolled, comprising 140 patients with pathological stage IA disease, 23 patients with pathological stage IB disease, 9 patients with pathological stage II disease, and 4 patients with pathological stage IIIA disease. No patients had recurrent disease, and three of the patients died within the follow-up period. The 5-year overall survival was 98.2% (95% confidence interval 94.4-99.4%) and the 5-year relapse-free survival was 98.2% (95% confidence interval 94.4-99.4%). Conclusions The long-term outcomes of stage I gastric cancer patients undergoing LADG seem comparable to those of patients undergoing an open procedure, although this result should be confirmed by a randomized control trial. We have already completed accrual of 921 patients for a multicenter randomized phase III trial (JCOG0912) to confirm the noninferiority of LADG compared with open gastrectomy in terms of relapse-free survival.

show abstract

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Although a minimally invasive surgical approach has received general acceptance [2][3][4], gastric cancer surgery remains a high-risk procedure that is associated with clinically significant postoperative stress, postgastrectomy syndrome, and other complications. The morbidity and mortality rates after radical gastrectomy have been reported as 9.1-28.1% and 0-1.3% respectively [2,[5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Protocol for enhanced recovery after surgery improves short-term outcomes for patients with gastric cancer: a randomized clinical trial

et al. 2017

View full text Add to dashboard Cite

Background The feasibility of the use of the enhanced recovery after surgery (ERAS) protocol in patients with gastric cancer remains unclear. Methods This study was a single-center, prospective randomized trial involving patients with gastric cancer undergoing curative gastrectomy. The primary end point was the length of postoperative hospital stay. Secondary end points were the postoperative complication rate, admission costs, weight loss, and amount of physical activity. Results From July 2013 to June 2015, we randomized 148 patients into an ERAS protocol group (n = 73) and a conventional protocol group (n = 69); six patients withdrew from the study. The hospital stay was significantly shorter in the ERAS protocol group than in the conventional protocol group (9 days vs 10 days; P = 0.037). The ERAS protocol group had a significantly lower rate of postoperative complications of grade III or higher (4.1% vs 15.4%; P = 0.042) and reduced costs of hospitalization (JPY 1,462,766 vs JPY 1,493,930; P = 0.045). The ratio of body weight to preoperative weight at 1 week and 1 month after the operation was higher in the ERAS protocol group (0.962 vs 0.957, P = 0.020, and 0.951 vs 0.937, P = 0.021, respectively). The ERAS protocol group recorded more physical activity in the first week after surgery.Conclusions The ERAS protocol is safe and efficient, and seems to improve the postoperative course of patients with gastric cancer.

show abstract

“…The benefits of minimally invasive surgical methods are proven and well published [6,[10][11][12][13][14][15][16]. With advantages such as decreased postoperative pain and shorter length of hospital stay, minimally invasive techniques are heralded as a significant development in the progress of general surgery.…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive surgery for gastric cancer: the American experience

et al. 2016

View full text Add to dashboard Cite

Background Minimally invasive surgical techniques are increasingly being implemented in oncologic care. This study assesses the impact of minimally invasive surgery on oncologic and perioperative outcomes in the management of gastric cancer in the USA. Methods From the American College of Surgeons and American Cancer Society National Cancer Data Base, we identified 6427 patients who underwent gastrectomy for cancer from 2010 to 2012. Treatment groups were categorized with an intention-to-treat paradigm as robotic, laparoscopic, and open surgery. Univariate and multivariate analyses were performed to estimate the impact of the surgical approach on oncologic and perioperative outcomes. Results Of patients undergoing definitive surgical intervention, 3.5 % (n = 223) underwent robotic gastrectomy, 23.1 % (n = 1487) underwent laparoscopic gastrectomy, and 73.4 % (n = 4717) underwent open surgery. Minimally invasive gastrectomy was more frequently performed on white (P = 0.018), privately insured patients (P = 0.049) treated at academic centers (P \ 0.0001) in the eastern USA (P \ 0.0001). After demographics, comorbidities, and tumor-related factors had been controlled for, patients who underwent laparoscopic gastrectomy had the postoperative length of stay decreased by 1.08 days (P \ 0.0001) and greater odds of having at least 15 lymph nodes resected (odds ratio 1.16, P = 0.023). Use of robotic surgery did not have a statistically significant effect on the postoperative length of stay relative to open surgery (P = 0.222) but the patients so treated had greater odds of having at least 15 lymph nodes resected (odds ratio 1.51, P = 0.005). There were no differences in R0 resection rates or perioperative mortality on the basis of the surgical approach alone. Conclusions These findings suggest that use of minimally invasive surgery for gastric cancer in the USA is impacting the adequacy of oncologic resection but is not yet having a clinically significant impact on perioperative outcomes relative to a conventional open approach.

show abstract

Long-Term Results of Laparoscopic Gastrectomy for Gastric Cancer: A Large-Scale Case-Control and Case-Matched Korean Multicenter Study

Abstract: The long-term oncologic outcomes of laparoscopic gastrectomy for patients with gastric cancer were comparable to those of open gastrectomy in a large-scale, multicenter, retrospective clinical study.

Cited by 290 publications

References 21 publications

Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)

Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)

Protocol for enhanced recovery after surgery improves short-term outcomes for patients with gastric cancer: a randomized clinical trial

Minimally invasive surgery for gastric cancer: the American experience

Contact Info

Product

Resources

About