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Laparoscopic gastrectomy for stage II and III advanced gastric cancer: long‑term follow‑up data from a Western multicenter retrospective study

Authors :
Felice Pirozzi
Vania Silvestri
Emanuele Pontecorvi
Roberto Peltrini
Giovanni Ferrari
Giovanni Merola
Diego Cuccurullo
Dragan Gunjic
Elisa Cassinotti
Antonio Sciuto
Paolo De Martini
Umberto Bracale
Giusto Pignata
Pasquale Dolce
Milos Bjelovic
Luigi Boni
Monica Gualtierotti
Stefano Olmi
Jacopo Andreuccetti
Francesco Corcione
Matteo Uccelli
Bracale, U.
Merola, G.
Pignata, G.
Andreuccetti, J.
Dolce, P.
Boni, L.
Cassinotti, E.
Olmi, S.
Uccelli, M.
Gualtierotti, M.
Ferrari, G.
De Martini, P.
Bjelovic, M.
Gunjic, D.
Silvestri, V.
Pontecorvi, E.
Peltrini, R.
Pirozzi, F.
Cuccurullo, D.
Sciuto, A.
Corcione, F.
Publication Year :
2022

Abstract

Introduction There has been an increasing interest for the laparoscopic treatment of early gastric cancer, especially among Eastern surgeons. However, the oncological effectiveness of Laparoscopic Gastrectomy (LG) for Advanced Gastric Cancer (AGC) remains a subject of debate, especially in Western countries where limited reports have been published. The aim of this paper is to retrospectively analyze short- and long-term results of LG for AGC in a real-life Western practice. Materials and methods All consecutive cases of LG with D2 lymphadenectomy for AGC performed from January 2005 to December 2019 at seven different surgical departments were analyzed retrospectively. The primary outcome was diseases-free survival (DFS). Secondary outcomes were overall survival (OS), number of retrieved lymph nodes, postoperative morbidity and conversion rate. Results A total of 366 patients with stage II and III AGC underwent either total or subtotal LG. The mean number of harvested lymph nodes was 25 ± 14. The mean hospital stay was 13 ± 10 days and overall postoperative morbidity rate 27.32%, with severe complications (grade ≥ III) accounting for 9.29%. The median follow-up was 36 ± 16 months during which 90 deaths occurred, all due to disease progression. The DFS and OS probability was equal to 0.85 (95% CI 0.81–0.89) and 0.94 (95% CI 0.92–0.97) at 1 year, 0.62 (95% CI 0.55–0.69) and 0.63 (95% CI 0.56–0.71) at 5 years, respectively. Conclusion Our study has led us to conclude that LG for AGC is feasible and safe in the general practice of Western institutions when performed by trained surgeons.

Details

Language :
English
Database :
OpenAIRE
Accession number :
edsair.doi.dedup.....a2aa3035fbefa2b509950c158577af97