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Short- and long-term outcomes of laparoscopic versus open gastrectomy for locally advanced gastric cancer following neoadjuvant chemotherapy

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Abstract

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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Authors and Affiliations

  1. Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Muneharu Fujisaki, Norio Mitsumori, Naoto Takahashi, Hiroaki Aoki, Yuya Nyumura, Seizo Kitazawa & Katsuhiko Yanaga

  2. Department of Surgery, Machida Municipal Hospital, Tokyo, Japan

    Muneharu Fujisaki & Toshihiko Shinohara

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  1. Muneharu Fujisaki
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  2. Norio Mitsumori
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Correspondence to Muneharu Fujisaki.

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Muneharu Fujisaki, Norio Mitsumori, Toshihiko Shinohara, Naoto Takahashi, Hiroaki Aoki, Yuya Nyumura, Seizo Kitazawa, and Katsuhiko Yanaga have no conflicts of interest or financial ties to disclose.

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Fujisaki, M., Mitsumori, N., Shinohara, T. et al. Short- and long-term outcomes of laparoscopic versus open gastrectomy for locally advanced gastric cancer following neoadjuvant chemotherapy. Surg Endosc 35, 1682–1690 (2021). https://doi.org/10.1007/s00464-020-07552-1

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