Skip to main content

Advertisement

SpringerLink
Log in

Risk of recurrence after laparoscopy-assisted radical gastrectomy for gastric cancer performed by a single surgeon

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The risk of recurrence after laparoscopy-assisted radical gastrectomy (LAG) was investigated.

Materials and methods

Clinical data of 398 consecutive patients who underwent radical gastrectomy with R0 resection for gastric cancer at Gyeongsang National University Hospital between January 2005 and December 2007 were reviewed retrospectively.

Results

Of the patients, 65.4% (n = 261) and 34.6% (n = 138) underwent LAG and open radical gastrectomy (OG), respectively. Of the LAG cases, 73.2% (n = 192), 10.7% (n = 28), 12.6% (n = 33), and 3.1% (n = 8) had stage I, II, III, and IV gastric cancer, respectively. All patients were followed up for a mean of 36.8 ± 13.7 months, and 14.6% (n = 58) had recurrence during the follow-up period. Univariate analysis revealed that tumor size, tumor–node–metastasis (TNM) stage, method of approach (LAG versus OG), and operation type were associated significantly with recurrence. Multivariate analysis revealed that only high TNM stage was significantly associated with recurrence (P = 0.00). While patients who underwent OG had higher incidence of recurrence than patients who underwent LAG, OG was not significantly associated with recurrence on multivariate analysis (P = 0.06).

Conclusions

LAG and OG did not differ significantly in terms of recurrence, even when used in advanced gastric cancer cases. Multivariate analysis revealed that high TNM stage was significantly associated with recurrence. Thus, LAG appears to be a safe and feasible procedure that has the potential to be an alternative to open surgery, even for advanced gastric cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Kamangar F, Dores GM, Anderson WF (2006) Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 24:2137–2150

    Article  PubMed  Google Scholar 

  2. Yang HK, Association IcotKGC (2007) 2004 Nationwide gastric cancer report in Korea. J Korean Gastric Cancer Assoc 7:47–54

    Google Scholar 

  3. Lee HJ, Yang HK, Ahn YO (2002) Gastric cancer in Korea. Gastric Cancer 5:177–182

    Article  PubMed  Google Scholar 

  4. Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4:146–148

    PubMed  CAS  Google Scholar 

  5. Horiuchi T, Shimomatsuya T, Chiba Y (2001) Laparoscopically assisted pylorus-preserving gastrectomy. Surg Endosc 15:325–328

    Article  PubMed  CAS  Google Scholar 

  6. Huscher CG, Anastasi A, Crafa F, Recher A, Lirici MM (2000) Laparoscopic gastric resections. Semin Laparosc Surg 7:26–54

    PubMed  CAS  Google Scholar 

  7. Mochiki E, Kamimura H, Haga N, Asao T, Kuwano H (2002) The technique of laparoscopically assisted total gastrectomy with jejunal interposition for early gastric cancer. Surg Endosc 16:540–544

    Article  PubMed  CAS  Google Scholar 

  8. Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A (1999) Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer 2:230–234

    Article  PubMed  Google Scholar 

  9. Uyama I, Sugioka A, Matsui H, Fujita J, Komori Y, Hatakawa Y, Hasumi A (2001) Laparoscopic side-to-side esophagogastrostomy using a linear stapler after proximal gastrectomy. Gastric Cancer 4:98–102

    Article  PubMed  CAS  Google Scholar 

  10. Kim YW, Baik YH, Yun YH, Nam BH, Kim DH, Choi IJ, Bae JM (2008) Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg 248:721–727

    Article  PubMed  Google Scholar 

  11. Adachi Y, Suematsu T, Shiraishi N, Katsuta T, Morimoto A, Kitano S, Akazawa K (1999) Quality of life after laparoscopy-assisted Billroth I gastrectomy. Ann Surg 229:49–54

    Article  PubMed  CAS  Google Scholar 

  12. Hwang SI, Kim HO, Yoo CH, Shin JH, Son BH (2009) Laparoscopic-assisted distal gastrectomy versus open distal gastrectomy for advanced gastric cancer. Surg Endosc 23:1252–1258

    Article  PubMed  Google Scholar 

  13. Lee J, Kim W (2009) Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer: analysis of consecutive 106 experiences. J Surg Oncol 100:693–698

    Article  PubMed  Google Scholar 

  14. Lee JH, Kim YW, Ryu KW, Lee JR, Kim CG, Choi IJ, Kook MC, Nam BH, Bae JM (2007) A phase-II clinical trial of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer patients. Ann Surg Oncol 14:3148–3153

    Article  PubMed  Google Scholar 

  15. Song KY, Kim SN, Park CH (2008) Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for gastric cancer: technical and oncologic aspects. Surg Endosc 22:655–659

    Article  PubMed  CAS  Google Scholar 

  16. Tokunaga M, Hiki N, Fukunaga T, Nohara K, Katayama H, Akashi Y, Ohyama S, Yamaguchi T (2009) Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection following standardization–a preliminary study. J Gastrointest Surg 13:1058–1063

    Article  PubMed  Google Scholar 

  17. Hur H, Jeon HM, Kim W (2008) Laparoscopy-assisted distal gastrectomy with D2 lymphadenectomy for T2b advanced gastric cancers: three years’ experience. J Surg Oncol 98:515–519

    Article  PubMed  Google Scholar 

  18. Japanese Gastric Cancer A (1998) Japanese classification of gastric carcinoma - 2nd English edition. Gastric Cancer 1:10–24

    Article  Google Scholar 

  19. Nakajima T (2002) Gastric cancer treatment guidelines in Japan. Gastric Cancer 5:1–5

    Article  PubMed  Google Scholar 

  20. Joo YT, Moon HG, Lee SH, Jeong CY, Jung EJ, Hong SC, Choi SK, Ha WS, Park ST, Lee YJ (2007) Laparoscopy-assisted distal gastrectomy with intracorporeal Billroth I stapled anastomosis using a hand access device for patients with gastric cancer. Surg Endosc 21:859–862

    Article  PubMed  Google Scholar 

  21. Kim SG, Lee YJ, Ha WS, Jung EJ, Ju YT, Jeong CY, Hong SC, Choi SK, Park ST, Bae K (2008) LATG with extracorporeal esophagojejunostomy: is this minimal invasive surgery for gastric cancer? J Laparoendosc Adv Surg Tech A 18:572–578

    Article  PubMed  Google Scholar 

  22. Goh PM, Khan AZ, So JB, Lomanto D, Cheah WK, Muthiah R, Gandhi A (2001) Early experience with laparoscopic radical gastrectomy for advanced gastric cancer. Surg Laparosc Endosc Percutan Tech 11:83–87

    PubMed  CAS  Google Scholar 

  23. Lee YJ, Ha WS, Park ST, Choi SK, Hong SC (2007) Port-site recurrence after laparoscopy-assisted gastrectomy: report of the first case. J Laparoendosc Adv Surg Tech A 17:455–457

    Article  PubMed  Google Scholar 

  24. Maehara Y, Moriguchi S, Yoshida M, Takahashi I, Korenaga D, Sugimachi K (1991) Splenectomy does not correlate with length of survival in patients undergoing curative total gastrectomy for gastric carcinoma. Univariate and multivariate analyses. Cancer 67:3006–3009

    Article  PubMed  CAS  Google Scholar 

  25. Adachi Y, Kamakura T, Mori M, Baba H, Maehara Y, Sugimachi K (1994) Prognostic significance of the number of positive lymph nodes in gastric carcinoma. Br J Surg 81:414–416

    Article  PubMed  CAS  Google Scholar 

  26. Koga S, Kaibara N, Iitsuka Y, Kudo H, Kimura A, Hiraoka H (1984) Prognostic significance of intraperitoneal free cancer cells in gastric cancer patients. J Cancer Res Clin Oncol 108:236–238

    Article  PubMed  CAS  Google Scholar 

  27. Tateishi M, Ichiyoshi Y, Kawano T, Toda T, Minamisono Y, Nagasaki S (1995) Recurrent pattern of digestive tract carcinoma in the Japanese: comparison of gastric cancer to colon cancer. Int Surg 80:41–44

    PubMed  CAS  Google Scholar 

  28. Herfarth C, Schlag P, Hohenberger P (1987) Surgical strategies in locoregional recurrences of gastrointestinal carcinoma. World J Surg 11:504–510

    Article  PubMed  CAS  Google Scholar 

  29. Wu B, Wu D, Wang M, Wang G (2008) Recurrence in patients following curative resection of early gastric carcinoma. J Surg Oncol 98:411–414

    Article  PubMed  Google Scholar 

  30. Lai JF, Kim S, Kim K, Li C, Oh SJ, Hyung WJ, Rha SY, Chung HC, Choi SH, Wang LB, Noh SH (2009) Prediction of recurrence of early gastric cancer after curative resection. Ann Surg Oncol 16:1896–1902

    Article  PubMed  Google Scholar 

  31. Deng J, Liang H, Sun D, Zhang R, Zhan H, Wang X (2008) Prognosis of gastric cancer patients with node-negative metastasis following curative resection: outcomes of the survival and recurrence. Can J Gastroenterol 22:835–839

    PubMed  Google Scholar 

  32. Ahn HS, Lee HJ, Yoo MW, Kim SG, Im JP, Kim SH, Kim WH, Lee KU, Yang HK (2009) Diagnostic accuracy of T and N stages with endoscopy, stomach protocol CT, and endoscopic ultrasonography in early gastric cancer. J Surg Oncol 99:20–27

    Article  PubMed  Google Scholar 

  33. Liakakos T, Misiakos EP, Macheras A (2009) Advanced gastric cancer: is laparoscopic gastrectomy safe? Surg Endosc 23:1161–1163

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Young-Suk Kim RN and Mi-Hee Jung AN for conducting telephone interviews.

Disclosures

Authors Sang-Ho Jeong, Young-Joon Lee, Soon-Tae Park, Sang-Kyung Choi, Soon-Chan Hong, Eun-Jung Jung, Young-tae Joo, Chi-Young Jeong, and Woo-Song Ha have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Surgery, Gyeongsang National University Hospital, 90 Chilam-dong, Jinju, Gyeongsang South Province, 660-702, South Korea

    Sang-Ho Jeong, Young-Joon Lee, Soon-Tae Park, Sang-Kyung Choi, Soon-Chan Hong, Eun-Jung Jung, Young-tae Joo, Chi-Young Jeong & Woo-Song Ha

  2. Gyeongnam Regional Cancer Center, Jinju, South Korea

    Sang-Ho Jeong, Young-Joon Lee, Soon-Tae Park, Sang-Kyung Choi, Soon-Chan Hong, Eun-Jung Jung, Young-tae Joo, Chi-Young Jeong & Woo-Song Ha

  3. Gyeongsang Institute of Health Sciences, Jinju, South Korea

    Sang-Ho Jeong, Young-Joon Lee, Soon-Tae Park, Sang-Kyung Choi, Soon-Chan Hong, Eun-Jung Jung, Young-tae Joo, Chi-Young Jeong & Woo-Song Ha

Authors
  1. Sang-Ho Jeong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Young-Joon Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Soon-Tae Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sang-Kyung Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Soon-Chan Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eun-Jung Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Young-tae Joo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chi-Young Jeong
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Woo-Song Ha
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Young-Joon Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jeong, SH., Lee, YJ., Park, ST. et al. Risk of recurrence after laparoscopy-assisted radical gastrectomy for gastric cancer performed by a single surgeon. Surg Endosc 25, 872–878 (2011). https://doi.org/10.1007/s00464-010-1286-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-010-1286-5

Keywords

Search

Navigation