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Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)

Background Laparoscopic gastrectomy has become a common surgical treatment for gastric cancer in eastern Asian countries. However, a large-scale prospective study to investigate the benefit of laparoscopy-assisted distal gastrectomy (LADG) regarding long-term outcomes has never been reported. We hav...

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Published in:Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2018, Vol.21 (1), p.155-161
Main Authors: Hiki, Naoki, Katai, Hitoshi, Mizusawa, Junki, Nakamura, Kenichi, Nakamori, Mikihito, Yoshikawa, Takaki, Kojima, Kazuyuki, Imamoto, Haruhiko, Ninomiya, Motoki, Kitano, Seigo, Terashima, Masanori
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container_title Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
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creator Hiki, Naoki
Katai, Hitoshi
Mizusawa, Junki
Nakamura, Kenichi
Nakamori, Mikihito
Yoshikawa, Takaki
Kojima, Kazuyuki
Imamoto, Haruhiko
Ninomiya, Motoki
Kitano, Seigo
Terashima, Masanori
description Background Laparoscopic gastrectomy has become a common surgical treatment for gastric cancer in eastern Asian countries. However, a large-scale prospective study to investigate the benefit of laparoscopy-assisted distal gastrectomy (LADG) regarding long-term outcomes has never been reported. We have already reported the short-term outcomes of this study. Here we report long-term outcomes as the secondary endpoints of this study after a 5-year follow-up period. Methods This study comprised patients with clinical stage I gastric cancer who were able to undergo a distal gastrectomy. LADG with D1 plus suprapancreatic lymph node dissection was performed by credentialed gastric surgeons who had each conducted at least 30 LADG and 30 open gastrectomy procedures. The primary endpoint was the proportion of patients who developed either anastomotic leakage or pancreatic fistula. The secondary endpoints included overall survival and relapse-free survival. Results From November 2007 to September 2008, 176 eligible patients were enrolled, comprising 140 patients with pathological stage IA disease, 23 patients with pathological stage IB disease, 9 patients with pathological stage II disease, and 4 patients with pathological stage IIIA disease. No patients had recurrent disease, and three of the patients died within the follow-up period. The 5-year overall survival was 98.2% (95% confidence interval 94.4–99.4%) and the 5-year relapse-free survival was 98.2% (95% confidence interval 94.4–99.4%). Conclusions The long-term outcomes of stage I gastric cancer patients undergoing LADG seem comparable to those of patients undergoing an open procedure, although this result should be confirmed by a randomized control trial. We have already completed accrual of 921 patients for a multicenter randomized phase III trial (JCOG0912) to confirm the noninferiority of LADG compared with open gastrectomy in terms of relapse-free survival.
doi_str_mv 10.1007/s10120-016-0687-0
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However, a large-scale prospective study to investigate the benefit of laparoscopy-assisted distal gastrectomy (LADG) regarding long-term outcomes has never been reported. We have already reported the short-term outcomes of this study. Here we report long-term outcomes as the secondary endpoints of this study after a 5-year follow-up period. Methods This study comprised patients with clinical stage I gastric cancer who were able to undergo a distal gastrectomy. LADG with D1 plus suprapancreatic lymph node dissection was performed by credentialed gastric surgeons who had each conducted at least 30 LADG and 30 open gastrectomy procedures. The primary endpoint was the proportion of patients who developed either anastomotic leakage or pancreatic fistula. The secondary endpoints included overall survival and relapse-free survival. Results From November 2007 to September 2008, 176 eligible patients were enrolled, comprising 140 patients with pathological stage IA disease, 23 patients with pathological stage IB disease, 9 patients with pathological stage II disease, and 4 patients with pathological stage IIIA disease. No patients had recurrent disease, and three of the patients died within the follow-up period. The 5-year overall survival was 98.2% (95% confidence interval 94.4–99.4%) and the 5-year relapse-free survival was 98.2% (95% confidence interval 94.4–99.4%). Conclusions The long-term outcomes of stage I gastric cancer patients undergoing LADG seem comparable to those of patients undergoing an open procedure, although this result should be confirmed by a randomized control trial. We have already completed accrual of 921 patients for a multicenter randomized phase III trial (JCOG0912) to confirm the noninferiority of LADG compared with open gastrectomy in terms of relapse-free survival.</description><identifier>ISSN: 1436-3291</identifier><identifier>EISSN: 1436-3305</identifier><identifier>DOI: 10.1007/s10120-016-0687-0</identifier><identifier>PMID: 28093654</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Abdominal Surgery ; Cancer Research ; Confidence intervals ; Fistulae ; Gastrectomy ; Gastric cancer ; Gastroenterology ; Laparoscopy ; Lymph nodes ; Medicine ; Medicine &amp; Public Health ; Oncology ; Original Article ; Pancreas ; Surgical Oncology ; Survival</subject><ispartof>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2018, Vol.21 (1), p.155-161</ispartof><rights>The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2017</rights><rights>Gastric Cancer is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-e9e26cf5a6cba3e9d181ee2b4626dc57da128500e2aaa383577f6f6f11800a43</citedby><cites>FETCH-LOGICAL-c439t-e9e26cf5a6cba3e9d181ee2b4626dc57da128500e2aaa383577f6f6f11800a43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28093654$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hiki, Naoki</creatorcontrib><creatorcontrib>Katai, Hitoshi</creatorcontrib><creatorcontrib>Mizusawa, Junki</creatorcontrib><creatorcontrib>Nakamura, Kenichi</creatorcontrib><creatorcontrib>Nakamori, Mikihito</creatorcontrib><creatorcontrib>Yoshikawa, Takaki</creatorcontrib><creatorcontrib>Kojima, Kazuyuki</creatorcontrib><creatorcontrib>Imamoto, Haruhiko</creatorcontrib><creatorcontrib>Ninomiya, Motoki</creatorcontrib><creatorcontrib>Kitano, Seigo</creatorcontrib><creatorcontrib>Terashima, Masanori</creatorcontrib><creatorcontrib>Stomach Cancer Study Group of Japan Clinical Oncology Group</creatorcontrib><creatorcontrib>On behalf of Stomach Cancer Study Group of Japan Clinical Oncology Group</creatorcontrib><title>Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)</title><title>Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association</title><addtitle>Gastric Cancer</addtitle><addtitle>Gastric Cancer</addtitle><description>Background Laparoscopic gastrectomy has become a common surgical treatment for gastric cancer in eastern Asian countries. However, a large-scale prospective study to investigate the benefit of laparoscopy-assisted distal gastrectomy (LADG) regarding long-term outcomes has never been reported. We have already reported the short-term outcomes of this study. Here we report long-term outcomes as the secondary endpoints of this study after a 5-year follow-up period. Methods This study comprised patients with clinical stage I gastric cancer who were able to undergo a distal gastrectomy. LADG with D1 plus suprapancreatic lymph node dissection was performed by credentialed gastric surgeons who had each conducted at least 30 LADG and 30 open gastrectomy procedures. The primary endpoint was the proportion of patients who developed either anastomotic leakage or pancreatic fistula. The secondary endpoints included overall survival and relapse-free survival. Results From November 2007 to September 2008, 176 eligible patients were enrolled, comprising 140 patients with pathological stage IA disease, 23 patients with pathological stage IB disease, 9 patients with pathological stage II disease, and 4 patients with pathological stage IIIA disease. No patients had recurrent disease, and three of the patients died within the follow-up period. The 5-year overall survival was 98.2% (95% confidence interval 94.4–99.4%) and the 5-year relapse-free survival was 98.2% (95% confidence interval 94.4–99.4%). Conclusions The long-term outcomes of stage I gastric cancer patients undergoing LADG seem comparable to those of patients undergoing an open procedure, although this result should be confirmed by a randomized control trial. 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However, a large-scale prospective study to investigate the benefit of laparoscopy-assisted distal gastrectomy (LADG) regarding long-term outcomes has never been reported. We have already reported the short-term outcomes of this study. Here we report long-term outcomes as the secondary endpoints of this study after a 5-year follow-up period. Methods This study comprised patients with clinical stage I gastric cancer who were able to undergo a distal gastrectomy. LADG with D1 plus suprapancreatic lymph node dissection was performed by credentialed gastric surgeons who had each conducted at least 30 LADG and 30 open gastrectomy procedures. The primary endpoint was the proportion of patients who developed either anastomotic leakage or pancreatic fistula. The secondary endpoints included overall survival and relapse-free survival. Results From November 2007 to September 2008, 176 eligible patients were enrolled, comprising 140 patients with pathological stage IA disease, 23 patients with pathological stage IB disease, 9 patients with pathological stage II disease, and 4 patients with pathological stage IIIA disease. No patients had recurrent disease, and three of the patients died within the follow-up period. The 5-year overall survival was 98.2% (95% confidence interval 94.4–99.4%) and the 5-year relapse-free survival was 98.2% (95% confidence interval 94.4–99.4%). Conclusions The long-term outcomes of stage I gastric cancer patients undergoing LADG seem comparable to those of patients undergoing an open procedure, although this result should be confirmed by a randomized control trial. We have already completed accrual of 921 patients for a multicenter randomized phase III trial (JCOG0912) to confirm the noninferiority of LADG compared with open gastrectomy in terms of relapse-free survival.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>28093654</pmid><doi>10.1007/s10120-016-0687-0</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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subjects Abdominal Surgery
Cancer Research
Confidence intervals
Fistulae
Gastrectomy
Gastric cancer
Gastroenterology
Laparoscopy
Lymph nodes
Medicine
Medicine & Public Health
Oncology
Original Article
Pancreas
Surgical Oncology
Survival
title Long-term outcomes of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG0703)
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