Long-term outcomes of laparoscopic versus open gastrectomy for advanced gastric cancer: A large cohort study

Background: The adequacy of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) treatment remains uncertain. There are few reports on the long-term outcomes of laparoscopic versus open gastrectomy (OG) in AGC using subgroups with adequate patient numbers; which may provide further evidence to validate the long-term efficacy of LAG in AGC. Methods: A retrospective cohort study included 1198 consecutive AGC patients underwent LAG or OG between September 2005 and October 2012 was conducted to compare the long-term outcomes. Results: Of the 1198 patients, 430 (35.9%) underwent LAG, and 768 (64.1%) underwent OG. Recurrences occurred in 203 patients (47.2%) in LAG group and in 387 patients (50.4%) in the OG group (P = 0.091). Five-year overall survival and disease-free survival rates of the two groups were similar, which is 51.2% vs. 46.7%, (P = 0.081) and 52.8% vs. 49.6%, (P = 0.091). The surgical approach (LAG or OG) did not influence the disease-free survival (HR 0.975, 95% CI 0.712 to 1.336; P = 0.875). Conclusions: This study suggests that LAG with D2 lymphadenectomy may be a feasible and safe procedure for AGC treatment. (C) 2018 Elsevier Inc. All rights reserved.