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378 Background: The safety of laparoscopic total gastrectomy (LTG) for the treatment of gastric cancer remains lack of clinical evidence. The aim of this study was to compare the safety of LTG for clinical stage I gastric cancer with the conventional open total gastrectomy (OTG). Methods: From January 2017 to September 2018, a total of 227 patients with clinical stage T1N0-1M0/T2N0M0 gastric cancer were enrolled in this clinical trial and randomly assigned to Laparoscopic Gastrectomy group (LG, n=113) or Open Gastrectomy group (OG, n=114). The morbidity and mortality within 30 days following surgery, the recovery course, and the postoperative hospital stay between LG group (n=105) and OG group (n=109) were compared. Clavien-Dindo classification system was used to stratify surgical complications. Results: The overall morbidity rate was not significantly different in each group (LG group: 19.05%; OG group: 20.18%; Rate difference [RD]: -1.14%, 95%CI, -11.75%-9.58%). Intraoperative complications occurred in 3 (2.86%) patients in LG group and 4 (3.67%) patients in OG group (RD: -0.81%, 95%CI, -6.52%-4.85%). In addition, there was no significant difference in the overall postoperative complication rate of 18.10% in LG group and 17.43% in OG group (RD: 0.66%, 95%CI, -9.61%-11.01%). Each subtypes of postoperative complication were not significantly different between groups. One patient in LG group died of intra-abdominal bleeding from splenic artery, and there was no significant difference in mortality between LG group and OG group (RD: 0.95%, 95%CI, -2.54%-5.20%). The distribution of severity was similar between the two groups. Conclusions: Experienced surgeons can safely perform LTG with lymphadenectomy for clinical stage I gastric cancer. Clinical trial information: NCT03007550.

e15541 Background: The role of aldehyde dehydrogenase 2 (ALDH 2) in alcohol metabolism has been ascertained, yet the association between ALDH2 genotype and the carcinogenesis of gastric cancer remains controversy. Methods: We retrospectively collected data of 292 subjects hospitalized in Zhongshan Hospital in Shanghai during March 2016 to September 2016. All subjects were divided into case group (identified with gastric cancer by postoperative pathology) and control group. Distribution of aldehyde dehydrogenase 2 genotype, drinking status along with other clinical variables were compared. Logistic regression model included age, gender, smoking and drinking status, family history and ALDH2 genotype. Adjusted odds ratios (ORs) were calculated. Results: There was a significant elevation of alchohol consumption in case group (P = 0.033). Subjects with ALDH2 *1/*2 and *2/*2 genotype showed less inclination for drinking than ALDH2 *1/*1 (P < 0.001). The risk for gastric cancer showed no differences among subjects with ALDH2 genotype adjusted drinking status [OR 1.121, 95% confidence interval (CI) 0.555-2.263 in Never/rare drinkers; OR 3.380, 95% CI 0.232-49.240 in Light drinkers and OR 2.416, 95% CI 0.326-14.151). Further analysis indicated that high body weight index (BMI) and heavy smoking were individual risk factors for gastric cancer among Light/heavy dringkers with ALDH2 *1/*2 or *2/*2 genotype (OR 84.736, P = 0.021 for BMI and OR 3.904, P = 0.037 for smoking). Conclusions: A dose-response relationship between alchohol consumption and risk for gastric cancer was observed in primary analysis. However ALDH2 genotype failed to modify the alchohol consumption. Our findings suggested that there might be other pathways to further explain the mechanisim of the role of alchohol consumption in carcinogenisis of gastric cancer.

e15544 Background: The incidence rate of proximal gastric cancer has been rising steadily, and laparoscopic total gastrectomy (LTG) has been widely adopted. However, the safety of LTG still lacks solid evidence to prove. The aim of this study was to evaluate morbidity and mortality of LTG, and determine the risk factors associated with early postoperative complications. Methods: A retrospective multicenter study was carried out in China, and medical records of 109 gastric cancer patients receiving LTG during September 2014 and June 2016 were retrieved from the database. Patient characteristics, surgical outcomes, and postoperative morbidities and mortalities were analyzed. Results: Morbidity and mortality rates were 22.0% and 0% respectively. Pulmonary infection (13.8%, n = 15) was the most common complication. Most complications were grade II (15.5%, n = 17) according to the Clavien-Dindo classification. Multivariable analysis identified comorbidity, type of reconstruction method (TLTG) were independent risk factors of early postoperative complications. Comorbidity was the only independent risk factor of complications graded more than II. Diabetes mellitus was found correlated with surgical complication in subgroup analysis. Conclusions: LTG is safe and technically feasible in treating gastric cancer. Careful selection of patients without comorbidity and applying laparoscopy-assisted total gastrectomy instead of totally laparoscopic total gastrectomy may decrease postoperative complications.

e15529 Background: Receptor of activated C kinase 1 (RACK1) is regarded as a scaffolding protein in multiple intracellular signal transduction pathways. Our previous works had demonstrated that RACK1 might involve in progression of gastric cancer, and could be a criterion to predict the good prognosis for the patients after surgical resection. The aim of this study is to explore the regulatory role of RACK1 in matrix metalloproteinase 10 (MMP10) autocrine, and which may be involved in invasion of gastric cancer. Methods: RACK1 knockdown gastric cell lines were established by shRNA. Secretion of cytokines secretion, as well as MMP10 was measured by antibody arrays and enzyme-linked immunosorbent assay. Cell migration and invasion was compared between normal and RACK1 knockdown cells. Pharmacological inhibitors were employed in searching specific signaling pathway. The correlation of RACK1 and MMP10 expression in gastric cancer samples was analyzed by Spearman’s ρ test. Results: Expression of MMP10 was substantially enhanced after knockdown of RACK1 in vitro, which contributed to enhanced migration and invasiveness of gastric cancer cells in autocrine manner. Specific inhibitors of NF-κB and c-Src, as well as overexpression of dominant-negative c-Src mutant, could suppress the expression of MMP10. Finally, an inverse correlation of RACK1 and IL-8 expression was confirmed in gastric cancer samples. Conclusions: Down-regulation of RACK1 resulted in the up-regulation of MMP10 in gastric cancer, which might enhance invasiveness via Src/NF-κB pathway partially.

// Yan Wang 1,* , Rong-yuan Zhuang 1,* , Yi-yi Yu 1 , Shan Yu 1 , Jun Hou 2 , Yuan Ji 2 , Yi-hong Sun 3 , Kun-tang Shen 3 , Zhen-bin Shen 3 , Feng-lin Liu 3 , Nai-qing Zhao 4 and Tian-shu Liu 1,5 1 Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai, China 2 Department of Pathology, Fudan University, Zhongshan Hospital, Shanghai, China 3 Department of General Surgery, Fudan University, Zhongshan Hospital, Shanghai, China 4 Department of Biostatistics and Social Medicine, School of Public Health, Fudan University, Shanghai, China 5 Center of Evidence-based Medicine, Fudan University, Shanghai, China * These authors are co-first authors and contributed equally to this work Correspondence to: Tian-shu Liu, email: // Keywords : locally advanced gastric cancer, preoperative chemotherapy, resection rate Received : May 07, 2016 Accepted : August 25, 2016 Published : September 01, 2016 Abstract Purpose We assessed the effectiveness of EOX (capecitabine, oxaliplatin and epirubicin) compared with XELOX (capecitabine and oxaliplatin) as preoperative chemotherapy for initially unresectable locally advanced gastric cancer. Methods This is a prospective observational study. Patients with unresectable locally advanced gastric cancer were performed EOX regimen or XELOX regimen at the discretion of the investigators. They were assessed for response every 2 cycles by CT (computed tomography) scan. A multidisciplinary team reassessed resectability after 4 cycles. The primary endpoint was the response rate. Secondary end points included the R0 resection rate, survival and adverse events. Results From November 2008 to May 2015, 242 patients were enrolled; 112 of them were assigned to EOX regimen and 130 to XELOX regimen. The response rates were 33.0% and 33.8% respectively in EOX group and XELOX group ( P = 0.997). After 4 cycles of chemotherapy, 63 patients (56.3%) in EOX group and 81 patients (62.3%) in XELOX group received radical operation ( P = 0.408). There was no significant difference in progress-free survival (PFS, 12.0m vs . 15.4m, P = 0.925) and overall survival (OS, 25.7m vs . 29.0m, P = 0.783) in two groups. In addition, more adverse effects occurred in EOX group, such as more leucopenia (22.3% vs . 10.0%, P = 0.014), neutropenia (23.2% vs . 11.5%, P = 0.025), fatigue (11.6% vs . 3.8%, P = 0.041) and vomiting (10.7% vs . 2.3%, P = 0.015). Conclusions For unresectable locally advanced gastric cancer patients, XELOX regimen showed similar effects in response rate, radical resection rate and survival benefits, but with less toxicity effects.