Comparative study of laparoscopic versus open radical gastrectomy in advanced gastric neuroendocrine carcinoma: Analysis from a high-volume institution

Abstract

Gastric neuroendocrine carcinomas (G-NECs) are rare. This study aimed to explore the feasibility and clinical efficacy of laparoscopic surgery in patients with advanced G-NECs. The clinicopathological data of 175G-NECs patients who underwent radical gastrectomy in a high-volume centre were collected. One hundred fifty-one cases with advanced G-NECs (laparoscopic gastrectomy [LG]=30, open gastrectomy [OG]=121) were finally selected for comparison of the short-term outcomes and oncologic efficacy. In the postoperative recovery, when comparing the OG group, the time to ambulation (3.2d vs. 2.6d, respectively, p=0.049), the time to first flatus (4.1d vs. 3.6d, respectively, p=0.050), the time to first soft diet (7.9d vs. 6.7d, respectively, p=0.007), and the postoperative hospital stay (13.1d vs. 11.4d, respectively, p=0.047) of the LG group were shorter. There was no significant difference in the postoperative complication rates between the OG and LG groups (19.8% vs. 23.3%, p=0.671). The 3-year overall survival (OS) rate was 57.0% in the OG group and 64.4% in the LG group (p=0.349). The 3-year disease-free survival (DFS) rate was 51.7% in the OG group and 57.4% in the LG group (p=0.357). There was no significant difference in the 3-year OS and DFS rates between the LG and OG groups at each stage. The recurrence rate was 35.5% in the OG group and 33.0% in the LG group (p=0.821). The short-term outcomes and oncologic efficacy of laparoscopic gastrectomy and open gastrectomy for advanced G-NECs are comparable.