Comparison of long-term oncologic outcomes of laparoscopic gastrectomy and open gastrectomy for advanced gastric cancer: A retrospective cohort study

Abstract

Purpose We investigated the long-term oncologic outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) for advanced gastric cancer (AGC) with a 5-year follow-up period. Methods Clinical data of 180 patients (109 LG and 71 OG) who underwent radical D2 gastrectomy for AGC at Gyeongsang National University Hospital between 2007 and 2009 were included. Survivals and predictors of these outcomes were analyzed. Results The mean follow-up period was 54.3 months. Recurrence was observed in 68 patients (37.8%). The 5-year disease-free survival (DFS) rate was 52.2% for all patients, 39.4% in the OG group, and 60.6% in the LG group. The 5-year DFS rates for OG and LG with respect to pathological stage were stage I, 87.5% and 84.2%, respectively (P=0.684); stage II, 55.0% and 77.3%, respectively (P=0.032); and stage III, 23.3% and 34.8%, respectively (P=0.265). The 5-year overall survival (OS) rate was 52.8% for all patients, 40.8% in the OG group, and 60.6% in the LG group. The 5-year OS rates for OG and LG with respect to pathological stage were stage I, 87.5% and 84.2%, respectively (P=0.753); stage II, 55.0% and 77.3%, respectively (P=0.034); and stage III, 25.6% and 34.8%, respectively (P=0.302). For survival, TMN cancer stage was statistically independent prognostic factors. Conclusion Our analysis revealed that LG for AGC had acceptable long-term oncologic outcomes comparable to the outcomes of conventional OG. Cancer stage was independent risk factors associated with survival. Keywords: Laparoscopic gastrectomy, Stomach neoplasms, Advanced gastric cancer, Survival, Recurrence