Comparison of laparoscopic versus open gastrectomy for gastric cancer

• Published in: Surgical oncology Vol. 35; pp. 14 - 21
• Main Authors: Li, Bofei, Yu-Hong Wong, Ian, Siu-Yin Chan, Fion, Chan, Kwan Kit, Lai-Yin Wong, Claudia, Law, Tsz-Ting, Yat-Yin Kwok, Jeanette, Law, Simon
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2020; Elsevier Limited
• Subjects: Age; Bias; Cancer; Chemotherapy; Complications; Demographics; Gastrectomy; Gastric cancer; Histology; Laparoscopic gastrectomy; Laparoscopy; Matching; Medical prognosis; Mortality; Multivariate analysis; Open gastrectomy; Patients; Peritoneum; Surgery; Surgical outcomes; Tumors; Hong Kong China; East Asia; China; Japan; Open gastrectomy; Gastric cancer; Laparoscopic gastrectomy
• ISSN: 0960-7404; 1879-3320
• DOI: 10.1016/j.suronc.2020.06.008

This study aimed to compare the short-term and long-term outcomes of laparoscopic gastrectomy (LG) and open gastrectomy (OG) for gastric cancer in a tertiary referral center in Hong Kong. Two hundred and ninety-four consecutive patients with gastric cancer who underwent radical gastrectomy with curative intent between January 2008 and December 2015 were analyzed. Data was prospectively collected and reviewed. Propensity score matching was applied at a ratio of 1:1 to compare the OG and LG groups. After propensity score matching, operation duration (294.7 vs 231.8min, P < 0.01) was significantly longer while estimated blood loss (191.6 vs 351.0 ml, P = 0.01) was significantly less in LG group compared with OG. There were no significant differences in postoperative complications and mortality between LG and OG groups (postoperative complication rate, 35.2% vs 40.7%, P = 0.69; 90-day mortality rate, 1.9% vs 3.7%, P = 1.00). Three-year OS and 3-yr DFS of patients who underwent LG was not inferior to that of patients who had OG (P = 0.34; P = 0.51). However, there were significantly more peritoneal recurrences among the OG group than LG group (P < 0.01). LG has comparable outcomes for gastric cancer, even in advanced tumors. We could appropriately increase the proportion of laparoscopic gastrectomy for gastric cancer. •This is the first report on this issue from Hong Kong.•Higher peritoneal recurrence rate was observed after OG than LG.•More liberal use of LG can be advocated outside high volume centers.