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Surgical Endoscopy
Published in: Surgical Endoscopy 7/2014

01-07-2014

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

Authors: Yanfeng Hu, Mingang Ying, Changming Huang, Hongbo Wei, Zhiwei Jiang, Xiang Peng, Jiankun Hu, Xiaohui Du, Baolin Wang, Feng Lin, Jian Xu, Guanglong Dong, Tingyu Mou, Guoxin Li, For the Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) Group

Published in: Surgical Endoscopy | Issue 7/2014

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Abstract

Background

Laparoscopy-assisted gastrectomy (LAG) has been indicated to be safe, feasible, and oncologically efficacious for the treatment of early gastric cancer by both retrospective and prospective studies. Although some reports have demonstrated that LAG was also a safe and technically feasible procedure for advanced gastric cancer (AGC), its oncologic outcomes have not yet been confirmed in a multicenter, large-scale study. The aim of this study was to evaluate the oncologic outcomes of LAG for AGC on a multicenter basis in China.

Methods

Data of 1,184 consecutive patients with locally AGC who underwent LAG with curative intent between February 2003 and December 2009 were collected from the Chinese Laparoscopic Gastrointestinal Surgery Study group database and retrospectively analyzed. Survival rates were estimated by the Kaplan–Meier method. Risk factors for recurrence and survival were evaluated by Cox regression models.

Results

Postoperatively, 121 patients (10.2 %) experienced complications, and 1 patient died (0.1 %). Median follow-up was 12 months. Recurrence was observed in 185 patients (16.7 %), including hematogenous (31 patients), peritoneal (52), locoregional (25), distant lymph node (LN) (8), mixed (63), and uncertain (6) recurrences. The cumulative 3-year overall survival and disease-free survival rates were 75.3 and 69.0 %, respectively. The 3-year overall survival and disease-free survival rates were 89.7 and 88.9 % for stage I tumors, 85.0 and 77.0 % for stage II, 60.5 and 59.3 % for stage III. Independent risk factors for recurrence were tumor size > 40 mm, intraoperative blood transfusion, and advanced tumor stage. For survival, age > 65 years, tumor size > 40 mm, and advanced tumor stage were independent risk factors.

Conclusions

In addition to being safe and technically feasible, LAG for locally AGC could also yield acceptable short-term oncologic outcomes.
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Metadata
Title
Oncologic outcomes of laparoscopy-assisted gastrectomy for advanced gastric cancer: a large-scale multicenter retrospective cohort study from China
Authors
Yanfeng Hu
Mingang Ying
Changming Huang
Hongbo Wei
Zhiwei Jiang
Xiang Peng
Jiankun Hu
Xiaohui Du
Baolin Wang
Feng Lin
Jian Xu
Guanglong Dong
Tingyu Mou
Guoxin Li
For the Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) Group
Publication date
01-07-2014
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 7/2014
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3426-9

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