Safety and Limitations of Laparoscopic Total Gastrectomy for Gastric Cancer: A Comparative Analysis of Short and Long-term Outcomes With Open Surgery.
Anticancer Res
; 44(4): 1759-1766, 2024 Apr.
Article
de En
| MEDLINE
| ID: mdl-38537974
ABSTRACT
BACKGROUND/AIM:
Laparoscopic gastrectomy is a standard treatment strategy for gastric cancer (GC); however, the clinical impact of laparoscopic total gastrectomy (LTG) on survival outcomes remains unclear. We compared the short- and long-term results of LTG with those of open total gastrectomy (OTG). PATIENTS ANDMETHODS:
Patients undergoing total gastrectomy with lymph node dissection for Stage I/II/III GC between 2010 and 2020 were retrospectively analyzed. Patients were classified into those undergoing LTG (n=143, LTG group) and OTG (n=173, OTG group). The primary outcome was relapse-free survival (RFS).RESULTS:
The LTG group exhibited a higher prevalence of early T and N factors, with pStage I/II/III distribution skewed toward early-stage in a ratio of 86/24/33 compared to 38/65/69 in the OTG group (p<0.001), respectively. Longer operation time (p<0.001), less blood loss (p<0.001), fewer grade 3-4 complications (p<0.001), and shorter hospital stay (p<0.001) were observed in the LTG than in the OTG group. LTG was associated with survival benefits for patients without indication for adjuvant chemotherapy [5-year RFS rate, 96.3% vs. 73.2%; hazard ratio (HR)=0.24; 95% confidence interval (CI)=0.10-0.56; p<0.001]. Among the eligibility criteria for adjuvant chemotherapy (Stage II/III excluding pT1 and pT3N0), while the LTG group received more frequently doublet-agent administration (56.5% vs. 11%, p<0.001), conversely, the OTG group exhibited slightly better long-term survival rates (5-year RFS rate, 33.9% vs. 50.2%; HR=1.31; 95%CI=0.82-2.10; p=0.251).CONCLUSION:
LTG contributed to favorable short-term outcomes and demonstrated improved long-term outcomes in early-stage GC; however, careful consideration of indications is warranted for advanced GC cases.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Tumeurs de l'estomac
/
Laparoscopie
Limites:
Humans
Langue:
En
Journal:
Anticancer Res
Année:
2024
Type de document:
Article
Pays d'affiliation:
Japon
Pays de publication:
Grèce