Laparoscopic versus open gastrectomy for gastric cancer: long-term oncologic results.
BACKGROUND
Data are lacking regarding the oncologic safety of laparoscopic gastrectomy (LG) for the treatment of gastric cancer. The aim of this study was to compare the long-term outcomes of LG with open gastrectomy (OG) for the treatment of gastric cancer.


METHODS
A total of 1,874 patients underwent curative distal or total gastrectomy for gastric adenocarcinoma between May 2003 and December 2009 and were included in this retrospective study. Recurrence-free survival and recurrence pattern were compared according to each tumor stage, and a subgroup analysis was performed in advanced gastric cancer patients who underwent D2 lymphadenectomy.


RESULTS
Of 1,874 patients, 816 were treated with OG and 1,058 with LG. No differences were observed in recurrence-free survival rates between the LG and the OG groups for any tumor stage. The number of harvested lymph nodes was similar between the two groups when analyzed according to tumor progression, operative procedure, and extent of lymphadenectomy. There were no differences between the 2 groups when we compared recurrence patterns after stratifying for tumor stage. The subgroup analysis in advanced gastric cancer patients who underwent D2 lymphadenectomy showed that there was no difference in the recurrence-free survival rates for any tumor stage between the 2 groups. Multivariate analysis indicated that the type of operative approach did not influence recurrence in either early or advanced gastric cancer patients.


CONCLUSIONS
LG for gastric cancer is an oncologically safe procedure with comparable long-term outcomes with OG.
Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea.
Ju-Hee
JH
Lee
Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea.
Chang Min
CM
Lee
Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea.
Sang-Yong
SY
Son
Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea.
Sang Hoon
SH
Ahn
Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea; Department of Surgery, Seoul National University College of Medicine, Gyeonggi-do, South Korea.
Do Joong
DJ
Park
Department of Surgery, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea; Department of Surgery, Seoul National University College of Medicine, Gyeonggi-do, South Korea. Electronic address: hhkim@snubh.org.
Hyung-Ho
HH
Kim
D000230:Adenocarcinoma / Q000453:epidemiology / Q000601:surgery*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000601:surgery*