Photo Credit: Shivendu Jauhari
The following is a summary of “Long-term oncological outcomes of minimally invasive versus open gastrectomy for cancer,” published in the December 2024 issue of Surgery by Abboretti et al.
Researchers conducted a retrospective study to compare long-term survival and recurrence outcomes in people after laparoscopic gastrectomy (LG) vs. open gastrectomy (OG) for gastric cancer.
They analyzed consecutive patients with gastric adenocarcinoma who underwent curative gastrectomy (December 2007 and December 2021). Clinical and pathological characteristics, survival, and recurrence were compared among patients who underwent LG, OG, or conversion to open surgery (CoG). The chi-square (χ2) test was used for categorical variables, and the Mann-Whitney U test for continuous variables. Survival was assessed using Kaplan-Meier and log-rank tests, and multivariable Cox regression analysis was performed.
The results showed 156 patients, 49 (31.4%) underwent LG, 93 (59.6%) underwent OG, and 14 (9%) underwent CoG. Baseline demographics were similar across all groups. The R0 resection rates were 75.5% for LG, 80.6% for OG, and 64.3% for CoG (P=0.489). Open surgery was associated with a higher mean lymph node yield (28.4±11.6) compared to LG (22.8±9.7) and CoG (26.5±12.3, P=0.036). Severe postoperative complications were higher in the CoG group (64.3%) compared to the OG (29%) and LG (32.7%) groups (P=0.035). The CoG group had significantly worse disease-free survival (P=0.012 vs. OG, P=0.003 vs. LG; 53.3% for OG, 62.7% for LG, and 28.1% for CoG), although OS was similar across all groups, 57.1% for OG, 62.7% for LG, and 32.7% for CoG (all P>0.005).
They concluded that LG provided similar OS rates to OG, although CoG resulted in higher postoperative complications and worse disease-free survival.
Source: americanjournalofsurgery.com/article/S0002-9610(24)00686-X/fulltext
