Oncologic outcomes of laparoscopy-assisted gastrectomy for advanced gastric cancer: a large-scale multicenter retrospective cohort study from China

Hu, Yanfeng; Ying, Mingang; Huang, Chang‐Ming; H, Wei; Jiang, Zhiwei; Xiang, Peng; Hu, Jian‐Kun; Du, Xiaohui; Wang, Baolin; Lin, Feng; Xu, Jian; Dong, Guanglong; Mou, Tingyu; Li, Guoxin

doi:10.1007/s00464-014-3426-9

Cited by 74 publications

(39 citation statements)

References 36 publications

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“…Above results indicated that the LAG group has obvious advantages in the postoperative recovery in spite of the obviously longer operative time and slightly more intraoperative blood loss. These results were consistent with results from previous studies (7,26).…”

Section: Discussionsupporting

confidence: 83%

Feasibility and safety comparison of laparoscopy-assisted versus open gastrectomy for advanced gastric carcinoma with D2 lymphadenectomy

Wang

Zhang

et al. 2016

Jpn. J. Clin. Oncol.

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Objective: Laparoscopy-assisted gastrectomy for advanced gastric cancer still remains controversial. The aim of this study is to compare oncologic feasibility and technical safety of laparoscopic versus open gastrectomy for advanced gastric cancer with D2 lymphadenectomy by comparing patients' short-term postoperative outcomes. Methods: One hundred and one patients with laparoscopy-assisted gastrectomy and 101 patients with open gastrectomy were one-to-one matched and then compared in terms of operative outcomes and hospital courses. Results: The laparoscopic group showed significantly longer operating time (297.4 vs. 198.1 min, P < 0.001), earlier first flatus time (2.8 vs. 3.6 days, P < 0.001), earlier diet start time (3.8 vs. 4.6 days, P < 0.001), shorter hospital stay (10.5 vs. 11.9 days, P < 0.001) and less morbidity (21.8 vs. 37.6%, P = 0.019). However, retrieval lymph nodes, intraoperative blood loss, transfused patients, postoperative fever and mortality were similar in the two groups. As for complications, incision infection (1.0 vs. 8.9%, P = 0.021) was significantly more common in the open group than in the laparoscopic group. In the subgroup comparisons of outcomes of laparoscopy-assisted gastrectomy, the tumor, node, metastasis III group showed significantly increased retrieval lymph nodes (37.2 vs. 31.0, P < 0.001), increased intraoperative blood loss (147.2 vs. 120.5 ml, P = 0.010), increased length of hospital stay (11.1 vs. 9.9 days, P < 0.001) and increased morbidity (32.6 vs. 13.8%, P = 0.024) when compared with the tumor, node, metastasis II group. Conclusions: Laparoscopy-assisted gastrectomy is feasible and safe for the treatment of advanced gastric cancer with D2 lymphadenectomy compared with open gastrectomy. Higher-level tumor stage (tumor, node, metastasis III) may increase the operative risk and should be performed with caution by surgeons with considerable experience of laparoscopic gastrectomy.

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Section: Discussionsupporting

confidence: 83%

Feasibility and safety comparison of laparoscopy-assisted versus open gastrectomy for advanced gastric carcinoma with D2 lymphadenectomy

Wang

Zhang

et al. 2016

Jpn. J. Clin. Oncol.

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“…Although surgery is the most effective treatment modality for patients with resectable tumors, due to the low rates of early detection and diagnosis, many patients with gastric cancer in China are diagnosed at an advanced and unresectable clinical stage. For advanced gastric cancer and for patients with recurrent cancer who are not suitable candidates for reoperation, chemotherapy remains the preferred treatment method (3). However, at present, intrinsic or acquired multidrug resistance (MDR) represents a major obstacle for successful cancer chemotherapy (4).…”

Section: Introductionmentioning

confidence: 99%

miR‑30 decreases multidrug resistance in human gastric cancer cells by modulating cell autophagy

Liu

Luan

et al. 2017

Exp Ther Med

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Abstract.Chemotherapy is an important treatment modality for gastric cancer, and multidrug resistance (MDR) represents a major obstacle for successful cancer chemotherapy. There is a lack of research on whether microRNA (miR)-30a regulation affects the chemosensitivity of resistant gastric cancer cells, and mechanisms underlying the effects of miR-30a on drug resistance and cell autophagy require further investigation. In the present study, the expression of miR-30a and its effects in cisplatin (CDDP)-resistant human gastric cancer cells were investigated. A CDDP-resistant variant of the SGC-7901 cell line (SGC-7901/CDDP) was established by exposing the cells to gradually increasing drug concentrations, and miR-30a expression was detected by reverse transcription-semi quantitative polymerase chain reaction (RT-sqPCR). To examine the effect of miR-30a expression in the SGC-7901/CDDP cells, miR30a mimics or negative control miRNA were transfected into the cells, and a Cell Counting Kit-8 assay was performed to analyze the chemosensitivity of the different cell groups. RT-sqPCR and western blot analysis were also used to measure MDR1 mRNA and P-glycoprotein expression, and the light chain (LC)3-II/LC3-I ratio. Furthermore, apoptosis induced by the chemotherapeutic CDDP in the different groups was assessed using flow cytometry. The results demonstrated that low expression of miR-30a was associated with chemoresistance in gastric cancer cells, and in the chemoresistant cell line SGC7901/CDDP, CDDP-induced apoptosis was weakened. Additionally, it was demonstrated that the LC3-II/LC3-I ratio was elevated in SGC7901/CDDP cells compared with chemosensitive SGC7901 cells (P<0.001), which could be attenuated by upregulating miR-30a expression (P<0.001 vs. SGC7901/CDDP control cells). These results suggested that autophagy may contribute to drug resistance in gastric cancer cells, and that the reduction of LC3-II in response to miR-30a overexpression may inhibit chemoresistance-associated autophagy in gastric cancer cells.

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“…With the development of advanced laparoscopic instrument, improved techniques, and accumulated experience of laparoscopic surgery as well, laparoscopy-assisted distal gastrectomy (LADG) has nowadays become a widely used procedure of choice for patients with gastric cancer (GC) located in the lower third of stomach in the Eastern countries, especially in Japan, Korea, and China, [1–6] where there is a high prevalence of GC. [7,8] The benefits of LADG, such as better visualization, less-estimated blood loss, [9] lower complication rate, [9,10] shorter length of hospital stays, [10,11] and better survival outcomes [1,6] have been well documented.…”

Section: Introductionmentioning

confidence: 99%

Learning curve for gastric cancer patients with laparoscopy-assisted distal gastrectomy

et al. 2016

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Oncologic outcomes of laparoscopy-assisted gastrectomy for advanced gastric cancer: a large-scale multicenter retrospective cohort study from China

Abstract: In addition to being safe and technically feasible, LAG for locally AGC could also yield acceptable short-term oncologic outcomes.

Cited by 74 publications

References 36 publications

Feasibility and safety comparison of laparoscopy-assisted versus open gastrectomy for advanced gastric carcinoma with D2 lymphadenectomy

Feasibility and safety comparison of laparoscopy-assisted versus open gastrectomy for advanced gastric carcinoma with D2 lymphadenectomy

miR‑30 decreases multidrug resistance in human gastric cancer cells by modulating cell autophagy

Learning curve for gastric cancer patients with laparoscopy-assisted distal gastrectomy

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