Journal
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
Volume 35, Issue 4, Pages 1682-1690Publisher
SPRINGER
DOI: 10.1007/s00464-020-07552-1
Keywords
Gastric cancer; Laparoscopic surgery; Neoadjuvant chemotherapy; Short-term outcome; Long-term outcome
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This study retrospectively investigated the short- and long-term outcomes of laparoscopic gastrectomy in patients with gastric cancer following neoadjuvant chemotherapy. The laparoscopic group showed lower intraoperative blood loss and shorter hospital stay compared to the open gastrectomy group. No significant differences were found in 5-year disease-free and overall survival rates between the two groups.
Background This study aimed to investigate the short- and long-term outcomes of laparoscopic gastrectomy (LG) in patients with advanced gastric cancer following neoadjuvant chemotherapy (NAC) to determine its safety and feasibility. Methods We retrospectively investigated 51 patients who underwent gastrectomy for locally advanced gastric cancer [cT3-4/N1-3 or macroscopic type 3 (> 80 mm) or type 4] following NAC between November 2009 and January 2018. After excluding two patients who underwent palliative surgery due to peritoneal dissemination, 49 patients were ultimately selected for this cohort study. The patients were then divided into the LG group and open gastrectomy (OG) group, after which the clinicopathological characteristics as well as short- and long-term outcomes were examined. Results Compared with the OG group, the LG group demonstrated a significantly lower amount of intraoperative blood loss and a shorter hospital stay. The overall complication rates were 10% (2 of 20 patients) and 24% (7 of 29 patients) in the LG and OG groups (P = 0.277), respectively. No significant differences in 5-year disease-free (LG 44.4% vs. OG 53.3%; P = 0.382) or overall survival rates (LG 46.9% vs. OG 54.0%; P = 0.422) were observed between the groups. Multivariate analysis revealed that the surgical procedure (LG vs. OG) was not an independent risk factor for disease-free (P = 0.645) or overall survival (P = 0.489). Conclusions LG may be a potential therapeutic option for patients with gastric cancer following NAC considering its high success rates and acceptable short- and long-term outcomes.
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