Laparoscopic versus Open Total Gastrectomy for Locally Advanced Gastric Cancer: Short and Long-Term Results

Sara Di Carlo, Leandro Siragusa, Alessia Fassari, Enrico Fiori, Francesca La Rovere, Paolo Izzo, Valeria Usai, Giuseppe Cavallaro, Marzia Franceschilli, Sirvjo Dhimolea, Simone Sibio
2022 Current Oncology  
Laparoscopic gastrectomy for early gastric cancer is widely accepted and routinely performed. However, it is still debated whether the laparoscopic approach is a valid alternative to open gastrectomy in advanced gastric cancer (AGC). The aim of this study is to compare short-and long-term outcomes of laparoscopic (LG) and open (OG) total gastrectomy with D2 lymphadenectomy in patients with AGC. Methods: A retrospective comparative study was conducted on patients who underwent LG and OG for ACG
more » ... etween January 2015 and December 2021. Primary endpoints were the following: recurrence rate, 3-year disease-free survival, 3-year and 5-year overall survival. Univariate and multivariate analysis was conducted to compare variables influencing outcomes and survival. Results: Ninety-two patients included: fifty-three OG and thirty-nine LG. No difference in morbidity and mortality. LG was associated with lower recurrence rates (OG 22.6% versus LG 12.8%, p = 0.048). No differences in 3-year and 5-year overall survival; 3-year disease-free survival was improved in the LG group on the univariate analysis but not after the multivariate one. LG was associated with longer operative time, lower blood loss and shorter hospital stay. Lymph node yield was higher in LG. Conclusion: LG for AGC seems to provide satisfactory clinical and oncological outcomes in medium volume centers, improved postoperative results and possibly lower recurrence rates.
doi:10.3390/curroncol29110665 pmid:36354725 pmcid:PMC9689079 fatcat:kutc5ablhrekpjdb4cwml5xcy4