Short- and long-term outcomes of laparoscopic versus open gastrectomy for locally advanced gastric cancer following neoadjuvant chemotherapy

369 Background: To investigate the oncological feasibility and technical safety of laparoscopic gastrectomy with D2 lymphadenectomy for advanced gastric cancer. Methods: 186 advanced gastric cancer patients treated by gastrectomy with D2 lymphadenectomy were eligible for inclusion including those with invasion into the muscularis propria, subserosa, and serosa without involvement of other organs, and stages N0–2 and M0. We retrospectively compared the short- and-long term outcomes between laparoscopic gastrectomy and open gastrectomy. Results: We analyzed short-term outcomes by comparing distal- with total gastrectomy results. We found no significant difference for distal gastrectomy for postoperative morbidity (laparoscopic vs. open: n = 4 (4.6%) vs. n = 1 (3.6%); p= 1.00). We also found no significant difference in postoperative morbidity for total gastrectomy (laparoscopic vs. open: n = 2 (4.0%) vs. n = 1 (4.0%); p= 1.00). No deaths occurred in any group. The entire cohort analysis revealed no statistically significant differences in overall- or recurrence-free survival between the laparoscopic and open groups. For overall survival, there were no significant differences between open and laparoscopic groups for clinical stage II or III ( p= 0.29 and 0.27, respectively), and for pathological stage II or III ( p= 0.88 and 0.86, respectively). For recurrence-free survival, there were no significant differences between open and laparoscopic groups for clinical stage II or III ( p= 0.63 and 0.60, respectively), and for pathological stage II or III (p = 0.98 and 0.72, respectively). Conclusions: Laparscopic gastrectomy for advanced gastric cancer compared favorably with open gastrectomy regarding short- and long-term outcomes. Clinical trial information: 160907.

Download Full-text

Oncological outcomes of laparoscopic versus open gastrectomy after neoadjuvant chemotherapy for locally advanced gastric cancer: a retrospective multicenter study

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02322-2 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Islam Khaled ◽

Pablo Priego ◽

Hany Soliman ◽

Mohammed Faisal ◽

Ihab Saad Ahmed

Keyword(s):

Gastric Cancer ◽

Neoadjuvant Chemotherapy ◽

Advanced Gastric Cancer ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Disease Free Survival ◽

Open Gastrectomy ◽

Oncological Outcomes ◽

Locally Advanced Gastric Cancer ◽

The Mean

Abstract Background The oncological outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) following neoadjuvant chemotherapy have been investigated in a few studies. Our purpose was to evaluate the oncological outcomes of LG and OG after neoadjuvant chemotherapy in patients with locally advanced gastric cancer (GC) and to determine the advantages, preferences, and ease of use of the two techniques after chemotherapy. Methods We conducted a retrospective chart review of all patients who underwent either OG (n = 43) or LG (n = 41). The neoadjuvant treatment regimen consisted of capecitabine plus oxaliplatin for three cycles, which was then repeated 6 to 12 weeks after the operation for four cycles. Results The hospital stay time and intraoperative blood loss in the LG group were significantly lower than those in the OG group. The mortality rate and the 3-year survival rate for patients in the LG group were comparable to those of patients in the OG group (4.6% vs. 9.7% and 68.3% vs. 58.1%, respectively). Similar trends were observed regarding the 3-year recurrence rate and metastasis. The mean survival time was 52.9 months (95% confidence interval [CI], 44.2–61.6) in the OG group compared with 43.3 (95% CI, 36.6–49.8) in the LG group. Likewise, the mean disease-free survival was 56.1 months (95% CI, 46.36–65.8) in the LG group compared with 50.9 months (95% CI, 44.6–57.2) in the OG group. Conclusion LG is a feasible and safe alternative to OG for patients with locally advanced GC receiving neoadjuvant chemotherapy.

Download Full-text

Correction to: Impact of the Interval Between Neoadjuvant Chemotherapy and Gastrectomy on Short- and Long-Term Outcomes for Patients with Advanced Gastric Cancer

Annals of Surgical Oncology ◽

10.1245/s10434-021-10462-8 ◽

2021 ◽

Author(s):

Augustinas Bausys ◽

Toomas Ümarik ◽

Martynas Luksta ◽

Arvo Reinsoo ◽

Rokas Rackauskas ◽

...

Keyword(s):

Gastric Cancer ◽

Neoadjuvant Chemotherapy ◽

Advanced Gastric Cancer ◽

Long Term Outcomes ◽

Short And Long Term

Download Full-text

Our Short- and Long-Term Results of Laparoscopic Gastrectomy in Locally Advanced Gastric Cancer

İstanbul Kanuni Sultan Süleyman Tıp Dergisi ◽

10.4274/iksstd.2021.71224 ◽

2021 ◽

Vol 13 (2) ◽

pp. 116-122

Author(s):

Serdar Çulcu ◽

Cemil Yüksel ◽

Salim Demirci ◽

Ali Ekrem Ünal ◽

Sancar Bayar ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Laparoscopic Gastrectomy ◽

Locally Advanced ◽

Long Term Results ◽

Locally Advanced Gastric Cancer ◽

Short And Long Term

Download Full-text

Oncological Outcomes of Laparoscopic Versus Open Gastrectomy after Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer: A Retrospective Multicenter Study

10.21203/rs.3.rs-62349/v2 ◽

2021 ◽

Author(s):

Islam Khaled ◽

Pablo Priego ◽

Hany Soliman ◽

Mohamed Faisal ◽

Ihab Saad

Keyword(s):

Gastric Cancer ◽

Neoadjuvant Chemotherapy ◽

Advanced Gastric Cancer ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Disease Free Survival ◽

Open Gastrectomy ◽

Oncological Outcomes ◽

Locally Advanced Gastric Cancer ◽

The Mean

Abstract Background The oncological outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) following neoadjuvant chemotherapy have been investigated in a few studies. Our purpose was to evaluate the oncological outcomes of LG and OG after neoadjuvant chemotherapy in patients with locally advanced gastric cancer (GC) and to determine the advantages, preferences, and ease of use of the two techniques after chemotherapy.Methods We conducted a retrospective chart review of all patients who underwent either OG (n = 43) or LG (n = 41). The neoadjuvant treatment regimen consisted of capecitabine plus oxaliplatin for three cycles, which was then repeated 6 to 12 weeks after the operation for four cycles.Results The hospital stay time and intraoperative blood loss in the LG group were significantly lower than those in the OG group. The mortality rate and the 3-year survival rate for patients in the LG group were comparable to those of patients in the OG group (4.6% vs. 9.7% and 68.3% vs. 58.1%, respectively). Similar trends were observed regarding the 3-year recurrence rate and metastasis. The mean survival time was 52.9 months (95% confidence interval [CI], 44.2–61.6) in the OG group compared with 43.3 (95% CI, 36.6–49.8) in the LG group. Likewise, the mean disease-free survival was 56.1 months (95% CI, 46.36–65.8) in the LG group compared with 50.9 months (95% CI, 44.6–57.2) in the OG group.Conclusion LG is a feasible and safe alternative to OG for patients with locally advanced GC receiving neoadjuvant chemotherapy.

Download Full-text

Optimal Timing to Surgery After Neoadjuvant Chemotherapy for Locally Advanced Gastric Cancer

Frontiers in Oncology ◽

10.3389/fonc.2020.613988 ◽

2020 ◽

Vol 10 ◽

Author(s):

Yinkui Wang ◽

Zining Liu ◽

Fei Shan ◽

Xiangji Ying ◽

Yan Zhang ◽

...

Keyword(s):

Gastric Cancer ◽

Postoperative Complications ◽

Neoadjuvant Chemotherapy ◽

Advanced Gastric Cancer ◽

Survival Benefit ◽

Locally Advanced ◽

Term Survival ◽

Locally Advanced Gastric Cancer ◽

The Impact

BackgroundThe relationship between time to surgery (TTS) and survival benefit is not sufficiently demonstrated by previous studies in locally advanced gastric cancer (LAGC). This study aims to assess the impact of TTS after neoadjuvant chemotherapy (NACT) on long-term and short-term outcomes in LAGC patients.MethodsData were collected from patients with LAGC who underwent NACT between January 2007 and January 2018 at our institution. Outcomes assessed were long-term survival, pathologic complete response (pCR) rate, and postoperative complications.ResultsThis cohort of 426 patients was divided into five groups by weeks of TTS. Under cox regression, compared to other groups, the 22–28 days and 29–35 days groups revealed a better OS (≤21 vs. 22–28 days: HR 1.54, 95% CI = 0.81–2.93, P = 0.185; 36–42 vs. 22–28 days: HR 2.20, 95% CI = 1.28−3.79, P = 0.004; 43–84 vs. 22–28 days: HR 1.83, 95% CI = 1.09–3.06, P = 0.022) and PFS (≤21 vs. 22–28 days: HR 1.54, 95% CI = 0.81–2.93, P = 0.256; 36–42 vs. 22–28 days: HR 2.20, 95% CI = 1.28−3.79, P = 0.111; 43–84 vs. 22–28 days: HR 1.83, 95% CI = 1.09–3.06, P = 0.047). Further analysis revealed a better prognosis in patients with TTS within 22–35 days (OS: HR 1.78 95% CI = 1.25−2.54, P = 0.001; PFS: HR 1.49, 95% CI = 1.07−2.08, P = 0.017). Postoperative stay was significantly higher in the ≤21 days group, while other parameters revealed no statistical significance (P > 0.05). Restricted cubic spline depicted the nonlinear relationship between TTS and OS/PFS.ConclusionPatients who received surgery within 3−5 weeks experienced the maximal survival benefit without an increase in postoperative complications or lowering the rate of pCR. Further investigations are warranted.

Download Full-text