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Erschienen in: Surgery Today 9/2013

01.09.2013 | Original Article

Survival outcome of laparoscopic gastrectomy for clinical early (cT1) gastric cancer

verfasst von: Keishi Yamashita, Shinichi Sakuramoto, Tomotaka Shibata, Masayuki Nemoto, Hiroaki Mieno, Natsuya Katada, Shiro Kikuchi, Masahiko Watanabe

Erschienen in: Surgery Today | Ausgabe 9/2013

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Abstract

Purposes

Laparoscopy-assisted gastrectomy (LAG) for clinical early (cT1) gastric cancer (EGC) is superior to open gastrectomy in terms of the short-term outcome; however, long-term survival outcome remains elusive.

Methods

Four hundred and ninety-one cT1 EGC patients who underwent LAG between 1998 and 2010 were registered to evaluate the survival outcome, including 237 patients who were observed for at least 5 years (long-term, L group), while 221 patients who were observed for at least 2–5 years (intermediate term, I group).

Results

There were 17 deaths, including 7 patients who developed recurrence (5 in pT1 and 2 in pT4a). Two fatal cases with pStage IIB were uniquely T1N3b. Six out of the 7 recurrences occurred within 2 years after surgery. The 237 patients in the L group included 6 of the recurrent deaths (2.5 %), while the 221 patients in the I group included 1 recurrent death (0.9 %). Recurrent sites of pathological T1 cases were the liver (n = 2), lung (n = 1), ovary (n = 1), and bone (n = 1), and no peritoneal or local recurrence was found.

Conclusions

Collectively, the survival outcome of EGC by LAG was excellent and LAG was acceptable as a therapeutic procedure for EGC.
Literatur
1.
Zurück zum Zitat Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146–8.PubMed Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146–8.PubMed
2.
Zurück zum Zitat Sakuramoto S, Kikuchi S, Kuroyama S, Futawatari N, Katada N, Kobayashi N, et al. Laparoscopy-assisted distal gastrectomy for early gastric cancer: experience with 111 consecutive patients. Surg Endosc. 2006;20:55–60.PubMedCrossRef Sakuramoto S, Kikuchi S, Kuroyama S, Futawatari N, Katada N, Kobayashi N, et al. Laparoscopy-assisted distal gastrectomy for early gastric cancer: experience with 111 consecutive patients. Surg Endosc. 2006;20:55–60.PubMedCrossRef
3.
Zurück zum Zitat Sakuramoto S, Yamashita K, Kikuchi S, Futawatari N, Katada N, Moriya H, et al. Clinical experience of laparoscopy-assisted proximal gastrectomy with Toupet-like partial fundoplication in early gastric cancer for preventing reflux esophagitis. J Am Coll Surg. 2009;209:344–51.PubMedCrossRef Sakuramoto S, Yamashita K, Kikuchi S, Futawatari N, Katada N, Moriya H, et al. Clinical experience of laparoscopy-assisted proximal gastrectomy with Toupet-like partial fundoplication in early gastric cancer for preventing reflux esophagitis. J Am Coll Surg. 2009;209:344–51.PubMedCrossRef
4.
Zurück zum Zitat Sakuramoto S, Kikuchi S, Futawatari N, Katada N, Moriya H, Hirai K, Yamashita K, et al. Laparoscopy-assisted pancreas- and spleen-preserving total gastrectomy for gastric cancer as compared with open total gastrectomy. Surg Endosc. 2009;23:2416–23.PubMedCrossRef Sakuramoto S, Kikuchi S, Futawatari N, Katada N, Moriya H, Hirai K, Yamashita K, et al. Laparoscopy-assisted pancreas- and spleen-preserving total gastrectomy for gastric cancer as compared with open total gastrectomy. Surg Endosc. 2009;23:2416–23.PubMedCrossRef
5.
Zurück zum Zitat Sakuramoto S, Kikuchi S, Futawatari N, Moriya H, Katada N, Yamashita K, et al. Technique of esophagojejunostomy using transoral placement of the pretilted anvil head after laparoscopic gastrectomy for gastric cancer. Surgery. 2010;147:742–7.PubMedCrossRef Sakuramoto S, Kikuchi S, Futawatari N, Moriya H, Katada N, Yamashita K, et al. Technique of esophagojejunostomy using transoral placement of the pretilted anvil head after laparoscopic gastrectomy for gastric cancer. Surgery. 2010;147:742–7.PubMedCrossRef
6.
Zurück zum Zitat Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245:68–72.PubMedCrossRef Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N. A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245:68–72.PubMedCrossRef
7.
Zurück zum Zitat Nozoe T, Iguchi T, Adachi E, Matsukuma A, Ezaki T. Preoperative elevation of serum C-reactive protein as an independent prognostic indicator for gastric cancer. Surg Today. 2011;41:510–3.PubMedCrossRef Nozoe T, Iguchi T, Adachi E, Matsukuma A, Ezaki T. Preoperative elevation of serum C-reactive protein as an independent prognostic indicator for gastric cancer. Surg Today. 2011;41:510–3.PubMedCrossRef
8.
Zurück zum Zitat Song J, Lee HJ, Cho GS, Han SU, Kim MC, Ryu SW, Kim W, et al. Recurrence following laparoscopy-assisted gastrectomy for gastric cancer: a multicenter retrospective analysis of 1,417 patients. Ann Surg Oncol. 2010;17:1777–86.PubMedCrossRef Song J, Lee HJ, Cho GS, Han SU, Kim MC, Ryu SW, Kim W, et al. Recurrence following laparoscopy-assisted gastrectomy for gastric cancer: a multicenter retrospective analysis of 1,417 patients. Ann Surg Oncol. 2010;17:1777–86.PubMedCrossRef
9.
Zurück zum Zitat Lee SW, Nomura E, Bouras G, Tokuhara T, Tsunemi S, Tanigawa N. Long-term oncological outcomes from laparoscopic gastrectomy for gastric cancer: a single-center experience of 601 consecutive resections. J Am Coll Surg. 2010;211:33–40.PubMedCrossRef Lee SW, Nomura E, Bouras G, Tokuhara T, Tsunemi S, Tanigawa N. Long-term oncological outcomes from laparoscopic gastrectomy for gastric cancer: a single-center experience of 601 consecutive resections. J Am Coll Surg. 2010;211:33–40.PubMedCrossRef
10.
Zurück zum Zitat Sakuramoto S, Yamashita K, Watanabe M. Appropriateness of splenectomy for advanced cancer located in the upper third of the stomach. Surg Endosc. 2010;24:1219–20.PubMedCrossRef Sakuramoto S, Yamashita K, Watanabe M. Appropriateness of splenectomy for advanced cancer located in the upper third of the stomach. Surg Endosc. 2010;24:1219–20.PubMedCrossRef
11.
Zurück zum Zitat The Japanese Gastric Cancer Association (JGCA). JGCA gastric cancer guidelines. 2nd ed. 2004. The Japanese Gastric Cancer Association (JGCA). JGCA gastric cancer guidelines. 2nd ed. 2004.
12.
Zurück zum Zitat Kikuchi S, Hirai K, Kuroyama S, Katada N, Sakuramoto S, Kobayashi N, et al. Role of endoscopic clipping for determining the resection line for tumors located in the middle or upper corpus of the stomach: experience with 100 gastrectomies for early gastric cancer. Anticancer Res. 2004;24:4163–8.PubMed Kikuchi S, Hirai K, Kuroyama S, Katada N, Sakuramoto S, Kobayashi N, et al. Role of endoscopic clipping for determining the resection line for tumors located in the middle or upper corpus of the stomach: experience with 100 gastrectomies for early gastric cancer. Anticancer Res. 2004;24:4163–8.PubMed
13.
Zurück zum Zitat The Japanese Gastric Cancer Association (JGCA). Japanese Classification of Gastric Cancer. 14th ed. 2010. The Japanese Gastric Cancer Association (JGCA). Japanese Classification of Gastric Cancer. 14th ed. 2010.
14.
Zurück zum Zitat Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357:1810–20.PubMedCrossRef Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med. 2007;357:1810–20.PubMedCrossRef
15.
Zurück zum Zitat Kim MC, Kim W, Kim HH, Ryu SW, Ryu SY, Song KY, et al. Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer: a large-scale Korean multicenter study. Ann Surg Oncol. 2008;15:2692–700.PubMedCrossRef Kim MC, Kim W, Kim HH, Ryu SW, Ryu SY, Song KY, et al. Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer: a large-scale Korean multicenter study. Ann Surg Oncol. 2008;15:2692–700.PubMedCrossRef
16.
Zurück zum Zitat Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report—a phase III multicenter, prospective, randomized trial (KLASS trial). Ann Surg. 2010;251:417–20.PubMedCrossRef Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report—a phase III multicenter, prospective, randomized trial (KLASS trial). Ann Surg. 2010;251:417–20.PubMedCrossRef
17.
Zurück zum Zitat Fujiwara M, Kodera Y, Misawa K, Kinoshita M, Kinoshita T, Miura S, et al. Longterm outcomes of early-stage gastric carcinoma patients treated with laparoscopy-assisted surgery. J Am Coll Surg. 2008;206:138–43.PubMedCrossRef Fujiwara M, Kodera Y, Misawa K, Kinoshita M, Kinoshita T, Miura S, et al. Longterm outcomes of early-stage gastric carcinoma patients treated with laparoscopy-assisted surgery. J Am Coll Surg. 2008;206:138–43.PubMedCrossRef
18.
Zurück zum Zitat Yamashita K, Sakuramoto S, Kikuchi S, Katada N, Kobayashi N, Watanabe M. Validation of staging systems for gastric cancer. Gastric Cancer. 2008;11:111–8.PubMedCrossRef Yamashita K, Sakuramoto S, Kikuchi S, Katada N, Kobayashi N, Watanabe M. Validation of staging systems for gastric cancer. Gastric Cancer. 2008;11:111–8.PubMedCrossRef
19.
Zurück zum Zitat Tokunaga M, Hiki N, Fukunaga T, Ohyama S, Yamada K, Yamaguchi T. Better prognosis of T2 gastric cancer with preoperative diagnosis of early gastric cancer. Ann Surg Oncol. 2009;16:1514–9.PubMedCrossRef Tokunaga M, Hiki N, Fukunaga T, Ohyama S, Yamada K, Yamaguchi T. Better prognosis of T2 gastric cancer with preoperative diagnosis of early gastric cancer. Ann Surg Oncol. 2009;16:1514–9.PubMedCrossRef
20.
Zurück zum Zitat Sun Z, Wang ZN, Zhu GL, Huang BJ, Li K, Xu Y, Li DM, Xu HM. Advanced gastric cancer with early cancer macroscopic appearance: is it worthy of D2 lymphadenectomy? Ann Surg Oncol. 2010;17:1278–90.PubMedCrossRef Sun Z, Wang ZN, Zhu GL, Huang BJ, Li K, Xu Y, Li DM, Xu HM. Advanced gastric cancer with early cancer macroscopic appearance: is it worthy of D2 lymphadenectomy? Ann Surg Oncol. 2010;17:1278–90.PubMedCrossRef
Metadaten
Titel
Survival outcome of laparoscopic gastrectomy for clinical early (cT1) gastric cancer
verfasst von
Keishi Yamashita
Shinichi Sakuramoto
Tomotaka Shibata
Masayuki Nemoto
Hiroaki Mieno
Natsuya Katada
Shiro Kikuchi
Masahiko Watanabe
Publikationsdatum
01.09.2013
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 9/2013
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-012-0388-1

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