title: Risk of recurrence after laparoscopy-assisted radical gastrectomy for gastric cancer performed by a single surgeon.
abstract: BACKGROUND
  The risk of recurrence after laparoscopy-assisted radical gastrectomy (LAG) was investigated.
  
  
  METHODS
  Clinical data of 398 consecutive patients who underwent radical gastrectomy with R0 resection for gastric cancer at Gyeongsang National University Hospital between January 2005 and December 2007 were reviewed retrospectively.
  
  
  RESULTS
  Of the patients, 65.4% (n = 261) and 34.6% (n = 138) underwent LAG and open radical gastrectomy (OG), respectively. Of the LAG cases, 73.2% (n = 192), 10.7% (n = 28), 12.6% (n = 33), and 3.1% (n = 8) had stage I, II, III, and IV gastric cancer, respectively. All patients were followed up for a mean of 36.8 ± 13.7 months, and 14.6% (n = 58) had recurrence during the follow-up period. Univariate analysis revealed that tumor size, tumor-node-metastasis (TNM) stage, method of approach (LAG versus OG), and operation type were associated significantly with recurrence. Multivariate analysis revealed that only high TNM stage was significantly associated with recurrence (P = 0.00). While patients who underwent OG had higher incidence of recurrence than patients who underwent LAG, OG was not significantly associated with recurrence on multivariate analysis (P = 0.06).
  
  
  CONCLUSIONS
  LAG and OG did not differ significantly in terms of recurrence, even when used in advanced gastric cancer cases. Multivariate analysis revealed that high TNM stage was significantly associated with recurrence. Thus, LAG appears to be a safe and feasible procedure that has the potential to be an alternative to open surgery, even for advanced gastric cancer.
authors.affiliation: Department of Surgery, Gyeongsang National University Hospital, Jinju, Gyeongsang South Province, South Korea.
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Jeong
authors.forename: Young-Joon
authors.initials: YJ
authors.lastname: Lee
authors.forename: Soon-Tae
authors.initials: ST
authors.lastname: Park
authors.forename: Sang-Kyung
authors.initials: SK
authors.lastname: Choi
authors.forename: Soon-Chan
authors.initials: SC
authors.lastname: Hong
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Jung
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Joo
authors.forename: Chi-Young
authors.initials: CY
authors.lastname: Jeong
authors.forename: Woo-Song
authors.initials: WS
authors.lastname: Ha
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D009366:Neoplasm Seeding; D009852:Omentum / Q000601:surgery; D010166:Palliative Care; D012189:Retrospective Studies; D012306:Risk; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents