Japan Digestive Disease Week 2022
International Session (Symposium)3 (JSGS, JSGE)
October 29, 14:30–17:00, Room 4 (Fukuoka International Congress Center Maun Hall)
IS-S3-Keynote Lecture
Survival outcomes of laparoscopy-assisted distal gastrectomy for locally advanced gastric cancer (JLSSG0901)
- 1
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine
- 2
- Oita University
Background
To address the controversy surrounding implementation of laparoscopic gastrectomy for advanced gastric cancer (AGC), we present the phase-3 results that compared the outcomes of laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) for locally AGC.
Methods
Patients with potentially curable AGC after distal gastrectomy with D2 lymph node dissection (LND) from 37 hospitals were included. Only qualified surgeons performed surgeries. The primary endpoint was a 5-year relapse-free survival (RFS), while the non-inferiority margin for the hazard ratio (HR) was set at 1·31. (UMIN 000003420).
Results
Between November 2009 and July 2016, 507 patients were randomly assigned to either the ODG group (n=255) or LADG group (n=252). In the efficacy analysis, the 5-year RFS was 73·9% (95% confidence interval [CI] 68·7-79·5) and 75·7% (95% CI 70·5-81·2) for the ODG and LADG groups, respectively; the HR was 0·96 (90% CI, 0·72 to 1·26; one-sided pnon-inferiority=0·032).
Conclusions
LADG with D2 LND for locally AGC was safely performed by qualified surgeons and was non-inferior to ODG in terms of 5-year RFS. This laparoscopic approach could become a standard treatment for locally AGC.
To address the controversy surrounding implementation of laparoscopic gastrectomy for advanced gastric cancer (AGC), we present the phase-3 results that compared the outcomes of laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) for locally AGC.
Methods
Patients with potentially curable AGC after distal gastrectomy with D2 lymph node dissection (LND) from 37 hospitals were included. Only qualified surgeons performed surgeries. The primary endpoint was a 5-year relapse-free survival (RFS), while the non-inferiority margin for the hazard ratio (HR) was set at 1·31. (UMIN 000003420).
Results
Between November 2009 and July 2016, 507 patients were randomly assigned to either the ODG group (n=255) or LADG group (n=252). In the efficacy analysis, the 5-year RFS was 73·9% (95% confidence interval [CI] 68·7-79·5) and 75·7% (95% CI 70·5-81·2) for the ODG and LADG groups, respectively; the HR was 0·96 (90% CI, 0·72 to 1·26; one-sided pnon-inferiority=0·032).
Conclusions
LADG with D2 LND for locally AGC was safely performed by qualified surgeons and was non-inferior to ODG in terms of 5-year RFS. This laparoscopic approach could become a standard treatment for locally AGC.
- Index Term 1: randomized controlled trial
- Index Term 2: advanced gastric cancer