title: Comparative analysis of five-year survival results of laparoscopy-assisted gastrectomy versus open gastrectomy for advanced gastric cancer: a case-control study using a propensity score method.
abstract: BACKGROUND
  The aim of this study was to investigate the surgical and oncologic outcomes of laparoscopy-assisted gastrectomy (LAG) and open gastrectomy (OG) for advanced gastric cancer (AGC) using the case-control method with a sufficient follow-up period.
  
  
  METHODS
  The authors retrospectively analyzed 89 patients who underwent LAG and 345 patients who underwent OG for AGC between August 1999 and June 2007. A total of 176 matched cases were included in the final analysis.
  
  
  RESULTS
  Except for tumor size and reconstruction, there were no statistically significant differences in the clinicopathological parameters between the two groups. Although operation time was significantly longer for LAG than OG (228.3 vs. 183.6 min, p < 0.0001), first flatus time and postoperative hospital stay without complications were significantly shorter in the LAG group (3.2 vs. 3.7 days, p < 0.0001; 7.0 vs. 10.4 days, p < 0.0001, respectively). Operation-related complications occurred in 7 cases (8.0%) in both groups. 13 patients (14.8%) in the LAG group and 15 patients (17.1%) in the OG group had recurrence. There was no statistically significant difference in the 5-year and disease-free survival rates between LAG and OG.
  
  
  CONCLUSIONS
  LAG for AGC might be considered to be a minimally invasive surgery in some selected cases, although a well-designed prospective study comparing LAG with OG for AGC is needed.
authors.affiliation: Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Ki-Han
authors.initials: KH
authors.lastname: Kim
authors.forename: Min-Chan
authors.initials: MC
authors.lastname: Kim
authors.forename: Ghap-Joong
authors.initials: GJ
authors.lastname: Jung
authors.forename: Hong-Jo
authors.initials: HJ
authors.lastname: Choi
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Jang
authors.forename: Hyuk-Chan
authors.initials: HC
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D016022:Case-Control Studies; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D061214:Patient Safety; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome