Long-Term Outcomes After Laparoscopy-Assisted Gastrectomy for Advanced Gastric Cancer: Analysis of Consecutive 106 Experiences

Background and Objectives: The purpose of this retrospective study is to suggest the possibility of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) through long-term outcomes. Methods: Of 283 patients with gastric cancer who underwent LAG with extraperigastric (D2) lymphadenectomy between January 2004 and February 2009, 106 were pathologically confirmed with AGC and analyzed. Results: There were 75 men and 31 women, with a mean age of 61.4 +/- 11.7 years. There were 32 total gastrectomies and 74 distal gastrectomies with D2 lymphadenectomy. The mean tumor size was 4.8 +/- 2.6 cm. The mean numbers of retrieved and metastatic lymph nodes were 34.3 +/- 15.3 and 5.4 +/- 8.7, respectively. There was no lymph node metastasis in 44 patients (41.5%), and there were 35 grade T2a, 51 T2b, and 20 T3 lesions. There were 10 operation-related morbidities (9.4%) and one postoperative death (0.9%) from hepatic failure. The overall and disease-free survival rates were 81.4% and 72.4%, respectively. Tumors recurred in 17 patients (16.0%) during the follow-up periods (median 21.5 months; range 2-60). Conclusions: LAG for AGC might be considered as a minimally invasive treatment in selected cases, but further study comparing it with open gastrectomy will be needed. J. Surg. Oncol. 2009;100:693-698. (C) 2009 Wiley-Liss, Inc.