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Surg Endosc ; 35(4): 1682-1690, 2021 04.
Article de Anglais | MEDLINE | ID: mdl-32277356

RÉSUMÉ

BACKGROUND: This study aimed to investigate the short- and long-term outcomes of laparoscopic gastrectomy (LG) in patients with advanced gastric cancer following neoadjuvant chemotherapy (NAC) to determine its safety and feasibility. METHODS: We retrospectively investigated 51 patients who underwent gastrectomy for locally advanced gastric cancer [cT3-4/N1-3 or macroscopic type 3 (> 80 mm) or type 4] following NAC between November 2009 and January 2018. After excluding two patients who underwent palliative surgery due to peritoneal dissemination, 49 patients were ultimately selected for this cohort study. The patients were then divided into the LG group and open gastrectomy (OG) group, after which the clinicopathological characteristics as well as short- and long-term outcomes were examined. RESULTS: Compared with the OG group, the LG group demonstrated a significantly lower amount of intraoperative blood loss and a shorter hospital stay. The overall complication rates were 10% (2 of 20 patients) and 24% (7 of 29 patients) in the LG and OG groups (P = 0.277), respectively. No significant differences in 5-year disease-free (LG 44.4% vs. OG 53.3%; P = 0.382) or overall survival rates (LG 46.9% vs. OG 54.0%; P = 0.422) were observed between the groups. Multivariate analysis revealed that the surgical procedure (LG vs. OG) was not an independent risk factor for disease-free (P = 0.645) or overall survival (P = 0.489). CONCLUSIONS: LG may be a potential therapeutic option for patients with gastric cancer following NAC considering its high success rates and acceptable short- and long-term outcomes.


Sujet(s)
Gastrectomie , Laparoscopie , Traitement néoadjuvant , Tumeurs de l'estomac/traitement médicamenteux , Tumeurs de l'estomac/chirurgie , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Survie sans rechute , Femelle , Humains , Estimation de Kaplan-Meier , Mâle , Adulte d'âge moyen , Analyse multifactorielle , Traitement néoadjuvant/effets indésirables , Stadification tumorale , Soins postopératoires , Études rétrospectives , Facteurs de risque , Tumeurs de l'estomac/anatomopathologie , Facteurs temps , Résultat thérapeutique
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