Assessment of open versus laparoscopy-assisted gastrectomy in lymph node-positive early gastric cancer: A retrospective cohort analysis

Ji Yeong An, Geon Ung Heo, Jae Ho Cheong, Woo Jin Hyung, Seung Ho Choi, Sung Hoon Noh

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    Abstract

    Background: Laparoscopy-assisted gastrectomy (LAG) is still limited for early gastric cancer (EGC) with low possibility of lymph node (LN) metastasis, due to the concern for incomplete LN dissection and controversial long-term outcomes. We assessed oncological outcomes of laparoscopy-assisted versus open gastrectomy (OG) for patients with LN positive EGC. Methods: Between 2003 and 2007, 204 patients underwent surgery for LN positive EGC. We evaluated adequacy of LN dissection and early and long-term outcomes after OG (n=162) and LAG (n=42). Results: Operative time was longer but hospital stay was shorter for LAG than OG. Postoperative complications occurred in 14 patients (8.6%) after OG and 1 patient (2.4%) after LAG (P=0.316). Mean number of retrieved LNs and number of retrieved and metastatic LNs for each station did not differ between the two groups. During median 35 months of follow-up, 14 patients (8.6%) developed recurrence after OG, compared with 4 patients (9.5%) after LAG (P=0.769). Overall 5-year disease-free survival was 89.9% and 89.7% after OG and LAG. Status of LN metastasis was the only independent prognostic factor for disease-free survival. Conclusions: LAG is an oncologically safe procedure even for LN positive EGC. Adequate LN dissection and comparable long-term outcomes to OG can be achieved by LAG.

    Original languageEnglish (US)
    Pages (from-to)77-81
    Number of pages5
    JournalJournal of surgical oncology
    Volume102
    Issue number1
    DOIs
    StatePublished - Jul 1 2010

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    Keywords

    • Early gastric cancer
    • Laparoscopy-assisted gastrectomy
    • Lymph node metastasis
    • Outcome

    ASJC Scopus subject areas

    • Surgery
    • Oncology

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