Abstract
Background
Although many reports have indicated the feasibility of laparoscopic gastrectomy (LG) regarding short-term surgical outcomes, the role of LG remains controversial because studies of long-term outcomes of LG are insufficient. The purpose of this study was to evaluate the long-term oncologic outcomes of patients who have undergone LG.
Methods
Between May 2003 and December 2009, 714 consecutive patients underwent LG for gastric cancer. After excluding operative mortality (n = 4) and a case of Krukenberg tumor that was not identified at the time of surgery (n = 1), a total of 709 patients were analyzed for long-term oncologic outcomes. Gastric cancer cases were analyzed according to the American Joint Committee on Cancer classification (seventh edition). Overall survival and relapse-free survival were estimated by using the Kaplan-Meier method.
Results
Median follow-up was 46.2 months. Postoperative recurrence was observed in 26 patients (3.7%). The instances of recurrence were as follows: seven peritoneal, six locoregional, five hematogenous, four distant lymph nodes, and four mixed recurrence. There were neither port-site nor wound site metastases. The 5-year relapse-free survival rates were: 95.8% in stage I, 83.4% in stage II, and 46.4% in stage III. Five-year overall survival rates were: 96.4% in stage I, 83.1% in stage II, and 50.2% in stage III. The independent risk factors for recurrence were T stage and N stage. For survival, age, T stage, and N stage were statistically independent prognostic factors
Conclusions
Our single-center study of a large patient series revealed that LG for gastric cancer had acceptable long-term oncologic outcomes comparable to those of conventional open surgery.
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Acknowledgment
This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1020410).
Disclosures
Drs. Kyung Ho Pak, Woo Jin Hyung, Taeil Son, Kazutaka Obama, Yanghee Woo, Hyoung-Il Kim, Ji Yeong An, Jong Won Kim, Jae-Ho Cheong, Seung Ho Choi, and Sung Hoon Noh have no conflicts of interest or financial ties to disclose.
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Pak, K.H., Hyung, W.J., Son, T. et al. Long-term oncologic outcomes of 714 consecutive laparoscopic gastrectomies for gastric cancer: results from the 7-year experience of a single institute. Surg Endosc 26, 130–136 (2012). https://doi.org/10.1007/s00464-011-1838-3
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DOI: https://doi.org/10.1007/s00464-011-1838-3