Long-term outcomes of laparoscopic versus open gastrectomy for advanced gastric cancer: A large cohort study

Abstract

BackgroundThe adequacy of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) treatment remains uncertain. There are few reports on the long-term outcomes of laparoscopic versus open gastrectomy (OG) in AGC using subgroups with adequate patient numbers; which may provide further evidence to validate the long-term efficacy of LAG in AGC. MethodsA retrospective cohort study included 1198 consecutive AGC patients underwent LAG or OG between September 2005 and October 2012 was conducted to compare the long-term outcomes. ResultsOf the 1198 patients, 430 (35.9%) underwent LAG, and 768 (64.1%) underwent OG. Recurrences occurred in 203 patients (47.2%) in LAG group and in 387 patients (50.4%) in the OG group (P = 0.091). Five-year overall survival and disease-free survival rates of the two groups were similar, which is 51.2% vs. 46.7%, (P = 0.081) and 52.8% vs. 49.6%, (P = 0.091). The surgical approach (LAG or OG) did not influence the disease-free survival (HR 0.975, 95% CI 0.712 to 1.336; P = 0.875). ConclusionsThis study suggests that LAG with D2 lymphadenectomy may be a feasible and safe procedure for AGC treatment.