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Survival outcomes of laparoscopic versus open total gastrectomy with nodal dissection for gastric cancer in a high‐volume Japanese center: A propensity score‐matched analysis

AIM: To compare the survival outcomes of laparoscopic total gastrectomy (LTG) with those of open total gastrectomy (OTG) in gastric cancer. METHODS: Using an in‐house database, this single‐center study reviewed clinical data for patients who underwent surgery for gastric adenocarcinoma in 2008–2018....

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Autores principales: Kinoshita, Takahiro, Akimoto, Eigo, Yura, Masahiro, Yoshida, Mitsumasa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9831884/
https://www.ncbi.nlm.nih.gov/pubmed/36643368
http://dx.doi.org/10.1002/ags3.12606
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author Kinoshita, Takahiro
Akimoto, Eigo
Yura, Masahiro
Yoshida, Mitsumasa
author_facet Kinoshita, Takahiro
Akimoto, Eigo
Yura, Masahiro
Yoshida, Mitsumasa
author_sort Kinoshita, Takahiro
collection PubMed
description AIM: To compare the survival outcomes of laparoscopic total gastrectomy (LTG) with those of open total gastrectomy (OTG) in gastric cancer. METHODS: Using an in‐house database, this single‐center study reviewed clinical data for patients who underwent surgery for gastric adenocarcinoma in 2008–2018. The patients were divided into an LTG group and an OTG group. RESULTS: Data for 638 patients were screened. After exclusions, 580 patients (LTG, n = 212; OTG, n = 368) were enrolled. Noting that the OTG group included more advanced tumors, 1:1 propensity score matching was implemented to reduce any selection bias, leaving 326 patients (LTG, n = 163; OTG, n = 163; pStage I/II/III = 147/87/92) for further analysis. The operation time was longer and blood loss was less in the LTG group. The postoperative hospital stay was shorter in the LTG group than in the OTG group (9 d vs 10 d;P = .040). There was no significant difference in the incidence of grade III or worse postoperative complications (8.9% vs 11.0%). Five‐year overall survival was better in the LTG group (84.9% vs 73.5%; P = .0010, log‐rank test), but there was no significant difference in overall survival according to pStage (I, 93.0% vs 89.0%; II, 85.8% vs 77.5%; III, 64.1% vs 52.5%). There was a similar trend in relapse‐free survival. Distribution of recurrence sites was comparable. CONCLUSION: LTG may provide survival outcomes similar to those of OTG when performed by an experienced surgical team. Further evidence is required for final conclusions, especially regarding its efficacy for stage II/III.
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spelling pubmed-98318842023-01-12 Survival outcomes of laparoscopic versus open total gastrectomy with nodal dissection for gastric cancer in a high‐volume Japanese center: A propensity score‐matched analysis Kinoshita, Takahiro Akimoto, Eigo Yura, Masahiro Yoshida, Mitsumasa Ann Gastroenterol Surg Original Articles AIM: To compare the survival outcomes of laparoscopic total gastrectomy (LTG) with those of open total gastrectomy (OTG) in gastric cancer. METHODS: Using an in‐house database, this single‐center study reviewed clinical data for patients who underwent surgery for gastric adenocarcinoma in 2008–2018. The patients were divided into an LTG group and an OTG group. RESULTS: Data for 638 patients were screened. After exclusions, 580 patients (LTG, n = 212; OTG, n = 368) were enrolled. Noting that the OTG group included more advanced tumors, 1:1 propensity score matching was implemented to reduce any selection bias, leaving 326 patients (LTG, n = 163; OTG, n = 163; pStage I/II/III = 147/87/92) for further analysis. The operation time was longer and blood loss was less in the LTG group. The postoperative hospital stay was shorter in the LTG group than in the OTG group (9 d vs 10 d;P = .040). There was no significant difference in the incidence of grade III or worse postoperative complications (8.9% vs 11.0%). Five‐year overall survival was better in the LTG group (84.9% vs 73.5%; P = .0010, log‐rank test), but there was no significant difference in overall survival according to pStage (I, 93.0% vs 89.0%; II, 85.8% vs 77.5%; III, 64.1% vs 52.5%). There was a similar trend in relapse‐free survival. Distribution of recurrence sites was comparable. CONCLUSION: LTG may provide survival outcomes similar to those of OTG when performed by an experienced surgical team. Further evidence is required for final conclusions, especially regarding its efficacy for stage II/III. John Wiley and Sons Inc. 2022-07-26 /pmc/articles/PMC9831884/ /pubmed/36643368 http://dx.doi.org/10.1002/ags3.12606 Text en © 2022 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Kinoshita, Takahiro
Akimoto, Eigo
Yura, Masahiro
Yoshida, Mitsumasa
Survival outcomes of laparoscopic versus open total gastrectomy with nodal dissection for gastric cancer in a high‐volume Japanese center: A propensity score‐matched analysis
title Survival outcomes of laparoscopic versus open total gastrectomy with nodal dissection for gastric cancer in a high‐volume Japanese center: A propensity score‐matched analysis
title_full Survival outcomes of laparoscopic versus open total gastrectomy with nodal dissection for gastric cancer in a high‐volume Japanese center: A propensity score‐matched analysis
title_fullStr Survival outcomes of laparoscopic versus open total gastrectomy with nodal dissection for gastric cancer in a high‐volume Japanese center: A propensity score‐matched analysis
title_full_unstemmed Survival outcomes of laparoscopic versus open total gastrectomy with nodal dissection for gastric cancer in a high‐volume Japanese center: A propensity score‐matched analysis
title_short Survival outcomes of laparoscopic versus open total gastrectomy with nodal dissection for gastric cancer in a high‐volume Japanese center: A propensity score‐matched analysis
title_sort survival outcomes of laparoscopic versus open total gastrectomy with nodal dissection for gastric cancer in a high‐volume japanese center: a propensity score‐matched analysis
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9831884/
https://www.ncbi.nlm.nih.gov/pubmed/36643368
http://dx.doi.org/10.1002/ags3.12606
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