Short-term surgical outcomes of a randomized controlled trial comparing laparoscopic versus open gastrectomy with D2 lymph node dissection for advanced gastric cancer

2017 ◽  
Vol 32 (5) ◽  
pp. 2427-2433 ◽  
Author(s):  
Yan Shi ◽  
Xianhui Xu ◽  
Yongliang Zhao ◽  
Feng Qian ◽  
Bo Tang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Randomized Controlled Trial ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Surgical Outcomes ◽  
Controlled Trial ◽  
Node Dissection ◽  
Short Term ◽  
D2 Lymph Node Dissection ◽  
Randomized Controlled

Short-term outcomes from a multi-institutional, phase III study of laparoscopic versus open distal gastrectomy with D2 lymph node dissection for locally advanced gastric cancer (JLSSG0901).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4029-4029 ◽  
Author(s):  
Sang-Woong Lee ◽  
Tsuyoshi Etoh ◽  
Tetsuji Ohyama ◽  
Noriyuki Inaki ◽  
Shinichi Sakuramoto ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Lymph Node Dissection ◽  
Distal Gastrectomy ◽  
Locally Advanced ◽  
Node Dissection ◽  
Short Term ◽  
D2 Lymph Node Dissection ◽  
Locally Advanced Gastric Cancer

4029 Background: The safety of laparoscopic gastrectomy for advanced gastric cancer is controversial. We conducted a multi-institutional, randomized controlled trial to compare short- and long-term outcomes of laparoscopic distal gastrectomy (LAP) with D2 lymph node dissection for advanced gastric cancer in comparison to open distal gastrectomy (OP) in Japan (UMIN000003420). We herein demonstrate short-term outcomes of this trial. Methods: Patients with potentially curable gastric cancer (T2-T4, N0-2 and M0) by distal gastrectomy were eligible for inclusion. Between November 2009 and July 2016, 507 patients were randomly assigned to either the LAP group (n = 252) or the OP group (n = 255). Only credentialed surgeons in both the procedures from 37 Japanese institutions participated in the study. The primary endpoint was 5-year relapse free survival. Secondary endpoints were 5-year overall survival, adverse events and short-term clinical outcomes. Results: According to study protocol, 47 patients among the total eligible patients were excluded because of distant metastasis or tumor extension intraoperatively. The remaining 460 patients underwent distal gastrectomy with D2 lymph node dissection and were analyzed as per protocol. Estimated blood loss was lower in LAP than in OP (30 vs. 150 ml, P < 0.001) and operative time was longer in LAP than in OP (291 vs. 205 min, P < 0.001). Post-operative analgesics use was less in LAP than in OP (38.3 vs. 53.6 %, P = 0.001), and first day of flatus was shorter in LAP than in OP (2 vs. 3 days, P < 0.001). There were no significant differences in all grade intra-operative complications (LAP 0.9% vs. OP 2.6%, P = 0.285). In addition, there were no significant differences in grade 3 and higher post-operative complications between the two groups (LAP 3.1% vs. OP 4.7%, P = 0.473). Hospital mortality was 0.4 % in each group. Conclusions: Credentialed surgeons could safely perform laparoscopic distal gastrectomy with D2 lymph node dissection for locally advanced gastric cancer. The laparoscopic approach could be accepted without increasing major surgical complications in this setting. Clinical trial information: 000003420.

scholarly journals Outcomes of Distal Gastrectomy for Elderly Patients With Advanced Gastric Cancer: Comparison With Non-Elderly Patients and the Utility of Laparoscopic Distal Gastrectomy for Elderly Patients

2021 ◽  
Vol 105 (1-3) ◽  
pp. 679-687
Author(s):  
Ayako Shimada ◽  
Satoru Ishii ◽  
Hiroto Tanaka ◽  
Tomomi Okamoto ◽  
Kohei Mishima ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Elderly Patients ◽  
Advanced Gastric Cancer ◽  
Surgical Outcomes ◽  
Distal Gastrectomy ◽  
The Elderly ◽  
Node Dissection ◽  
D2 Lymph Node Dissection ◽  
Significant Difference

Background As the elderly population increases, cases of elderly advanced gastric cancer (AGC) also increase. This study aims to investigate the safety and utility of curative gastrectomy, as well as the efficacy of laparoscopic gastrectomy, for these elderly patients. Methods We retrospectively analyzed the surgical outcomes of patients with cStage IB-III AGC who underwent distal gastrectomy (DG) with D2 lymph node dissection in our institution. We compared the results between elderly patients (&gt;75 years) and non-elderly patients (&lt;75 years). We further divided the elderly patients into 2 groups: those who underwent laparoscopic DG (LDG) and those who underwent open DG (ODG). Further, we compared the results of the 2 groups. Results From January 2014 to March 2019, 84 patients underwent DG with D2 lymph node dissection for cStage IB-III AGC (52 elderly patients and 32 non-elderly patients). ASA was significantly higher in elderly patients; however, there was no significant difference in surgical outcomes nor in overall survival (OS) and recurrence-free survival (RFS) between the 2 groups. Among 52 elderly patients, 19 had LDG, whereas 33 had ODG. The LDG group had a significantly shorter length of hospital stay and a significantly less amount of blood loss. There was no significant difference in RFS and OS between these 2 groups. Conclusions Safety and oncologic curability may be achieved in elderly patients with AGC. LDG may be safely performed as ODG in elderly patients with AGC and it is expected to benefit them by achieving minimally invasive surgery.

scholarly journals Short Term Efficacy of Laparoscopy Assisted vs Open Gastrectomy with D2 Lymph Node Dissection for Advanced Gastric Cancer

2018 ◽  
Vol 51 (3) ◽  
pp. 324-329
Author(s):  
Bulent Aksel ◽  
Niyazi Karaman ◽  
Lutfi Dogan ◽  
Bahadir Ondes ◽  
Mehmet Ali Gulcelik
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Lymph Node Dissection ◽  
Open Gastrectomy ◽  
Node Dissection ◽  
Short Term ◽  
D2 Lymph Node Dissection ◽  
Term Efficacy
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