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Comparison of long-term results between laparoscopy-assisted gastrectomy and open gastrectomy with D2 lymph node dissection for advanced gastric cancer

Byline: Atsushi Hamabe (1), Takeshi Omori (1), Koji Tanaka (1), Toshirou Nishida (1) Keywords: Gastrectomy; Gastric cancer; Laparoscopic surgery; Lymph node excision Abstract: Background Laparoscopy-assisted gastrectomy (LAG) has been established as a low-invasive surgery for early gastric cancer. H... Full description

Journal Title: Surgical Endoscopy 2012, Vol.26(6), pp.1702-1709
Main Author: Hamabe, Atsushi
Other Authors: Omori, Takeshi , Tanaka, Koji , Nishida, Toshirou
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0930-2794 ; E-ISSN: 1432-2218 ; DOI: 10.1007/s00464-011-2096-0
Link: http://dx.doi.org/10.1007/s00464-011-2096-0
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recordid: springer_jour10.1007/s00464-011-2096-0
title: Comparison of long-term results between laparoscopy-assisted gastrectomy and open gastrectomy with D2 lymph node dissection for advanced gastric cancer
format: Article
creator:
  • Hamabe, Atsushi
  • Omori, Takeshi
  • Tanaka, Koji
  • Nishida, Toshirou
subjects:
  • Gastrectomy
  • Gastric cancer
  • Laparoscopic surgery
  • Lymph node excision
ispartof: Surgical Endoscopy, 2012, Vol.26(6), pp.1702-1709
description: Byline: Atsushi Hamabe (1), Takeshi Omori (1), Koji Tanaka (1), Toshirou Nishida (1) Keywords: Gastrectomy; Gastric cancer; Laparoscopic surgery; Lymph node excision Abstract: Background Laparoscopy-assisted gastrectomy (LAG) has been established as a low-invasive surgery for early gastric cancer. However, it remains unknown whether it is applicable also for advanced gastric cancer, mainly because the long-term results of LAG with D2 lymph node dissection for advanced gastric cancer have not been well validated compared with open gastrectomy (OG). Methods A retrospective cohort study was performed to compare LAG and OG with D2 lymph node dissection. For this study, 167 patients (66 LAG and 101 OG patients) who underwent gastrectomy with D2 lymph node dissection for advanced gastric cancer were reviewed. Recurrence-free survival and overall survival time were estimated using Kaplan--Meier curves. Stratified log-rank statistical evaluation was used to compare the difference between the LAG and OG groups stratified by histologic type, pathologic T status, N status, and postoperative adjuvant chemotherapy. The adjusted Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of LAG. Results The 5-year recurrence-free survival rate was 89.6% in the LAG group and 75.8% in the OG group (nonsignificant difference stratified log-rank statistic, 3.11 P = 0.0777). The adjusted HR of recurrence for LAG compared with OG was 0.389 [95% confidence interval (CI) 0.131--1.151]. The 5-year overall survival rate was 94.4% in the LAG group and 78.5% in the OG group (nonsignificant difference stratified log-rank statistic, 0.4817 P = 0.4877). The adjusted HR of death for LAG compared with OG was 0.633 (95% CI 0.172--2.325). Conclusions The findings show that LAG with D2 lymph node dissection is acceptable in terms of long-term results for advanced gastric cancer cases and may be applicable for advanced gastric cancer treatment. Author Affiliation: (1) Department of Surgery, Osaka Police Hospital, 10-31, Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan Article History: Registration Date: 29/11/2011 Received Date: 03/10/2011 Accepted Date: 26/11/2011 Online Date: 30/12/2011
language: eng
source:
identifier: ISSN: 0930-2794 ; E-ISSN: 1432-2218 ; DOI: 10.1007/s00464-011-2096-0
fulltext: fulltext
issn:
  • 1432-2218
  • 14322218
  • 0930-2794
  • 09302794
url: Link


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titleComparison of long-term results between laparoscopy-assisted gastrectomy and open gastrectomy with D2 lymph node dissection for advanced gastric cancer
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descriptionByline: Atsushi Hamabe (1), Takeshi Omori (1), Koji Tanaka (1), Toshirou Nishida (1) Keywords: Gastrectomy; Gastric cancer; Laparoscopic surgery; Lymph node excision Abstract: Background Laparoscopy-assisted gastrectomy (LAG) has been established as a low-invasive surgery for early gastric cancer. However, it remains unknown whether it is applicable also for advanced gastric cancer, mainly because the long-term results of LAG with D2 lymph node dissection for advanced gastric cancer have not been well validated compared with open gastrectomy (OG). Methods A retrospective cohort study was performed to compare LAG and OG with D2 lymph node dissection. For this study, 167 patients (66 LAG and 101 OG patients) who underwent gastrectomy with D2 lymph node dissection for advanced gastric cancer were reviewed. Recurrence-free survival and overall survival time were estimated using Kaplan--Meier curves. Stratified log-rank statistical evaluation was used to compare the difference between the LAG and OG groups stratified by histologic type, pathologic T status, N status, and postoperative adjuvant chemotherapy. The adjusted Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of LAG. Results The 5-year recurrence-free survival rate was 89.6% in the LAG group and 75.8% in the OG group (nonsignificant difference stratified log-rank statistic, 3.11 P = 0.0777). The adjusted HR of recurrence for LAG compared with OG was 0.389 [95% confidence interval (CI) 0.131--1.151]. The 5-year overall survival rate was 94.4% in the LAG group and 78.5% in the OG group (nonsignificant difference stratified log-rank statistic, 0.4817 P = 0.4877). The adjusted HR of death for LAG compared with OG was 0.633 (95% CI 0.172--2.325). Conclusions The findings show that LAG with D2 lymph node dissection is acceptable in terms of long-term results for advanced gastric cancer cases and may be applicable for advanced gastric cancer treatment. Author Affiliation: (1) Department of Surgery, Osaka Police Hospital, 10-31, Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan Article History: Registration Date: 29/11/2011 Received Date: 03/10/2011 Accepted Date: 26/11/2011 Online Date: 30/12/2011
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