Risk of recurrence after laparoscopy-assisted radical gastrectomy for gastric cancer performed by a single surgeon

Abstract

LAG and OG did not differ significantly in terms of recurrence, even when used in advanced gastric cancer cases. Multivariate analysis revealed that high TNM stage was significantly associated with recurrence. Thus, LAG appears to be a safe and feasible procedure that has the potential to be an alternative to open surgery, even for advanced gastric cancer.

Laparoscopic gastrectomy and impact on recurrence of gastric cancer

“…Based on the paradigm of advanced colon cancer with evidence that laparoscopic colectomy in stage II/III has no negative effect on disease-free survival, the trend is to evaluate the safety and efficacy of laparoscopic gastrectomy in advanced stages. The study by Jeong et al [1] supports the safety of laparoscopic surgery for advanced gastric cancer. However, this study is limited by its retrospective nature and relatively small number of patients in each TNM stage.…”

“…To highlight this crucial question, Jeong et al [1] performed a retrospective study and reported the results in the March issue of Surgical Endoscopy. The authors evaluated the clinicopathologic, treatment, and survival follow-up data of 398 patients with gastric cancer who underwent an R0 resection.…”

“…For stage IV tumors in particular, an R0 resection is difficult to achieve even with open surgery in Europe or the U.S., and most of these patients are currently treated with neoadjuvant chemotherapy or chemoradiotherapy. In the study by Jeong et al [1], 41 patients with stage III/IV cancer were treated with laparoscopic R0 gastrectomy but for reality in the West, it is a hard task.…”

Minimally invasive surgery for stomach cancer

“…A small-scale RCT and several retrospective studies have demonstrated no significant differences in survival rate, recurrence rate and type of recurrence between LAG and COG (12,(24)(25)(26). Furthermore, a retrospective study by multivariate analysis found that depth of invasion and progression of lymph node metastasis were determinants of prognosis, indicating that survival was not an issue of approach, i.e.…”

“…Furthermore, a retrospective study by multivariate analysis found that depth of invasion and progression of lymph node metastasis were determinants of prognosis, indicating that survival was not an issue of approach, i.e. laparoscopy versus laparotomy (25). However, observation periods were <5 years in most studies, and prospective studies were conducted in a small scale, and therefore, it must be said that evidence that the long-term outcomes of laparoscopy are equivalent to those of laparotomy is still insufficient.…”