Laparoscopic gastrectomy for gastric cancer: has the time come for considered it a standard procedure?

• Published in: Surgical oncology Vol. 40; p. 101699
• Main Authors: Caruso, Stefano, Scatizzi, Marco
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.03.2022; Elsevier Limited
• Subjects: Adequacy; Cancer; Clinical trials; Gastrectomy; Gastric cancer; Gastrointestinal surgery; Hospitals; Humans; Laparoscopic gastrectomy; Laparoscopy; Literature reviews; Lymphatic system; Meta-analysis; Minimally invasive surgery; Mortality; Neoplasm Staging; Oncology; Patient Selection; Recovery (Medical); Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgical outcomes; Tumors; Japan; Minimally invasive surgery; Laparoscopic gastrectomy; Gastrectomy; Gastric cancer
• ISSN: 0960-7404; 1879-3320; 1879-3320
• DOI: 10.1016/j.suronc.2021.101699

Radical gastrectomy with an adequate lymphadenectomy is the main procedure which makes it possible to cure patients with resectable gastric cancer. A number of randomized controlled trials and meta-analysis provide phase III evidence that laparoscopic gastrectomy is technically safe and that it yields better short-term outcomes than conventional open gastrectomy for early-stage gastric cancer. At present, laparoscopic gastrectomy is considered a standard procedure for early-stage gastric cancer, especially in Asian countries. On the other hand, the use of minimally invasive techniques is still controversial for the treatment of more advanced tumours, principally due to existing concerns about its oncological adequacy and capacity to carry out an adequately extended lymphadenectomy. Additional high-quality studies comparing laparoscopic gastrectomy versus open gastrectomy for gastric cancer have been recently published, in particular concerning the latest results obtained by laparoscopic approach to advanced gastric cancer. It seems very useful to update the review of literature in light of these new evidences for this subject and draw some considerations. •Laparoscopic gastrectomy is a worldwide diffuse procedure for stage I gastric cancer.•The application of laparoscopic surgery in advanced gastric cancer is debated.•Awaited results of randomized trials on laparoscopic gastrectomy are now available.•The emerging evidence will condition the drafting of the next future guidelines.•An update of the current knowledge is highly advisable to draw final consideration.