Roux Stasis Syndrome and Gastric Food Stasis After Laparoscopic Distal Gastrectomy with Uncut Roux-en-Y Reconstruction in Gastric Cancer Patients: A Propensity Score Matching Analysis

135 Background: The aim of this study is to investigate the oncologic outcomes as well as short-term outcomes of laparoscopic distal gastrectomy compared with open distal gastrectomy for advanced gastric cancer using propensity-score matching analysis. Methods: A total of 384 patients underwent distal gastrectomy for advanced gastric cancer from July 2006 to November 2016. Data on short- and long-term outcomes were collected prospectively and reviewed. Propensity-score matching was applied at a ratio of 1:1 comparing the laparoscopic distal gastrectomy (LDG) group and open distal gastrectomy (ODG) groups. Results: The LDG group showed longer operative time than the ODG group. However, resumption of diet and length of hospital stay were shorter in the LDG group than in the ODG group (4.7 vs. 5.6 days, p= 0.049 and 9.6 vs. 11.5 days, p= 0.035, respectively).The extent of lymph node dissection in the LDG group was more limited than in the ODG group ( p= 0.002), although there was no difference in the number of retrieved lymph nodes between the two groups. The 3-year overall survival rates were 98% and 86.9% ( p= 0.018), whereas the 3-year recurrence-free survival were 86.3% and 75.3%, p= 0.259) in the LDG and the ODG groups. Conclusions: Laparoscopic distal gastrectomy is safe and feasible for advanced gastric cancer in terms of earlier recovery after surgery and long-term oncologic outcomes.

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Short-Term Outcomes of Three-Port Totally Laparoscopic Distal Gastrectomy in the Treatment of Gastric Cancer: Comparison with a Four-Port Approach Using a Propensity Score Matching Analysis

Journal of Laparoendoscopic & Advanced Surgical Techniques ◽

10.1089/lap.2016.0083 ◽

2016 ◽

Vol 26 (7) ◽

pp. 531-535 ◽

Cited By ~ 5

Author(s):

Ho Seok Seo ◽

Han Hong Lee

Keyword(s):

Gastric Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Distal Gastrectomy ◽

Laparoscopic Distal Gastrectomy ◽

Short Term ◽

Propensity Score Matching Analysis ◽

Totally Laparoscopic Distal Gastrectomy ◽

Totally Laparoscopic

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Impact of adjuvant chemotherapy with S-1 on survival in patients with type 4 and large type 3 gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.98 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 98-98

Author(s):

Hayato Omori ◽

Sanae Kaji ◽

Rie Makuuchi ◽

Tomoyuki Irino ◽

Yutaka Tanizawa ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Propensity Score ◽

Propensity Score Matching ◽

Cancer Patients ◽

Strong Impact ◽

Large Type ◽

Gastric Cancer Patients ◽

Type 3 ◽

The Impact

98 Background: The prognosis of patients with linitis plastica (type 4) and large ulcero-invasive-type (type 3) gastric cancer is reported to be extremely poor. In stage II/III gastric cancer, adjuvant chemotherapy with S-1 is a standard treatment in Japan. However, the efficacy of postoperative chemotherapy with S-1 in these types of patients with dismal prognosis is unknown. The aim of this study is to evaluate the impact of adjuvant chemotherapy with S-1 on survival in type 4 and large type 3 gastric cancer patients. Methods: A total of 152 patients with clinically resectable type 4 and large type 3 gastric cancer who underwent R0 or R1 surgery from 2002 to 2014 were included. The survival outcome between patents with surgery alone and patients who received adjuvant S-1 was compared using a 1:1 propensity score matching method. Results: Patients with adjuvant S-1 were significantly younger (67 vs 74 y, p = 0.009), had higher incidence of T4 (90 vs 62%, p < 0.001), N2-3 (84 vs 63%, p = 0.008), and cytology positive (52 vs 29%, p = 0.006) than in surgery alone patients. Before matching, median survival time (MST) was not different in surgery alone (n = 52) and adjuvant S-1 (n = 100) (31.3 vs 35.8 months, p = 0.41). Propensity score matching yielded 48 patients (24 patients in each group). After matching, baseline characteristics were well balanced between the two groups. Survival in patients with adjuvant S-1 was significantly better than in surgery alone patients (MST: 50.3 vs 15.4 months, p = 0.002). Cox proportional hazard analysis revealed adjuvant S-1 treatment was selected as independent prognostic factor (HR: 0.38, 95%CI: 0.18-0.76, p = 0.006), as well as lavage cytology (HR: 3.9, 95%CI: 1.8-8.9, p < 0.001). Conclusions: Adjuvant chemotherapy with S-1 may have a strong impact on survival in type 4 and large type 3 gastric cancer patients. The efficacy of this treatment will be further demonstrated in the future clinical trials.

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