title: Long-term outcomes of laparoscopy-assisted distal gastrectomy for early gastric cancer: result of a randomized controlled trial (COACT 0301).
abstract: BACKGROUND
  The purpose of this study was to evaluate laparoscopy-assisted distal gastrectomy (LADG) compared to open distal gastrectomy (ODG) in the treatment of early gastric cancer with respect to survival, surgical outcomes, complications, and quality of life (QOL).
  
  
  METHODS
  One hundred sixty-four patients with cT1N0M0 and cT1N1M0 distal gastric cancer were randomly assigned to either the LADG group or the ODG group. The primary end point was the 5-year disease-free survival (DFS) rate. Complications were classified using the accordion severity classification of postoperative complications scheme. QOL was measured using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-STO22 preoperatively and postoperatively during regular follow-up visits. This trial is registered at ClinicalTrials.gov (NCT00546468).
  
  
  RESULTS
  The median (range) follow-up period was 74.3 (24.8-90.8) months. The LADG and ODG groups showed similar survival [5-year DFS rate: 98.8 % vs. 97.6 %, respectively (P = 0.514), 5-year overall survival (OS) rate: 97.6 vs. 96.3 %, respectively (P = 0.721)] or overall complication rate (29.3 vs. 42.7 %, respectively; P = 0.073). Mild complications were significantly less frequent in the LADG group than in the ODG group (23.2 vs. 41.5 %; P = 0.012). The rates of moderate, severe, and long-term complications (i.e., 31 days to 5 years after surgery) did not differ significantly between groups. No clinically meaningful differences were detected between the two groups in long-term QOL.
  
  
  CONCLUSIONS
  LADG showed similar DFS and OS compared to ODG in treating early gastric cancer. Marginal benefits in mild complications were observed with LADG. LADG did not show advantages over ODG regarding other complications and long-term QOL.
authors.affiliation: Gastric Cancer Branch, Research Institute & Hospital, National Cancer Center, 809 Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do, 411-764, Republic of Korea, gskim@ncc.re.kr.
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
authors.forename: Hong Man
authors.initials: HM
authors.lastname: Yoon
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Yun
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Nam
authors.forename: Bang Wool
authors.initials: BW
authors.lastname: Eom
authors.forename: Yong Hae
authors.initials: YH
authors.lastname: Baik
authors.forename: Sang Eok
authors.initials: SE
authors.lastname: Lee
authors.forename: Yeji
authors.initials: Y
authors.lastname: Lee
authors.forename: Young-ae
authors.initials: YA
authors.lastname: Kim
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Park
authors.forename: Keun Won
authors.initials: KW
authors.lastname: Ryu
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000523:psychology; D011788:Quality of Life; D055502:Secondary Prevention; D013274:Stomach Neoplasms / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome