Introduction
Materials and methods
Patients
Diagnostics and treatment
Outcomes
Statistical analysis
Results
Patient characteristics
Open | Laparoscopy |
p
| |||
---|---|---|---|---|---|
n = 1663 | % |
n = 277 | % | ||
Age at diagnosis (years) [mean (± SD)] | 68.4 | [11.9] | 68.5 | [11.5] | 0.961 |
Gender | 0.935 | ||||
Male | 1035 | (62) | 173 | (63) | |
Female | 628 | (38) | 104 | (37) | |
Malignancy history | 202 | (12) | 30 | (11) | 0.516 |
Neoadjuvant treatment | 858 | (52) | 175 | (63) | <0.001 |
Chemotherapy | 844 | (51) | 170 | (61) | |
Chemoradiotherapy | 12 | (<1) | 4 | (1) | |
Radiotherapy | 2 | (<1) | 1 | (<1) | |
Tumor location | <0.001 | ||||
Proximal (cardia/fundus/corpus) | 450 | (27) | 114 | (41) | |
Distal (antrum/pylorus) | 746 | (45) | 103 | (37) | |
Overlapping | 304 | (18) | 44 | (16) | |
Not specified | 163 | (10) | 16 | (6) | |
Resection | <0.001 | ||||
Partial | 1109 | (67) | 140 | (51) | |
Total | 554 | (33) | 137 | (49) | |
Conversions | – | – | 24 | (9) | |
pT stage | 0.370 | ||||
T0 | 70 | (4) | 16 | (6) | |
T1–2 | 609 | (37) | 105 | (39) | |
T3–4 | 972 | (59) | 152 | (56) | |
Tx | 12 | 4 | |||
pN stage | 0.691 | ||||
N0 | 827 | (51) | 143 | (52) | |
N+ | 798 | (49) | 131 | (48) | |
Nx | 38 | 3 | |||
Tumor differentiation | 0.553 | ||||
Well–moderate | 336 | (20) | 63 | (23) | |
Poor | 787 | (47) | 123 | (44) | |
Unknown | 540 | (33) | 186 | (33) | |
In-hospital mortality | 79 | (5) | 13 | (5) | 0.701 |
<90-day mortality | 128 | (8) | 17 | (6) | 0.404 |
Hospital stay (days) [median (range)] | 10 | [2–377] | 8 | [1–94] | <0.001 |
Adjuvant treatment | 533 | (32) | 120 | (43) | <0.001 |
Chemotherapy | 408 | (25) | 97 | (35) | |
Chemoradiotherapy | 122 | (7) | 23 | (8) | |
Radiotherapy | 3 | (<1) | 0 | (0) |
Lymph node yield
Lymph node yield ≥15 | R+ resection rate | 1-year overall survival | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Univariable | Multivariable | Univariable | Multivariable | Univariable | Multivariable | |||||||||||||
OR | [95% CI] |
p
| OR | [95% CI] |
p
| OR | [95% CI] |
p
| OR | [95% CI] |
p
| HR | [95% CI] |
p
| HR | [95% CI] |
p
| |
MIG |
1.63
|
[1.25–2.14]
|
<0.001
| 1.01 | [0.75–1.36] | 0.944 | 0.74 | [0.48–1.12] | 0.156 | 0.86 | [0.54–1.37] | 0.523 | 1.01 | [0.77–1.32] | 0.969 | 0.99 | [0.75–1.32] | 0.962 |
Age ≥65 |
0.63
|
[0.52–0.77]
|
<0.001
|
0.76
|
[0.61–0.95]
|
0.015
| 1.01 | [0.76–1.36] | 0.936 | - | - | - |
1.61
|
[1.29–2.01]
|
<0.001
|
1.50
|
[1.18–1.91]
|
0.001
|
Female gender | 1.05 | [0.88–1.27] | 0.579 | - | - | - | 1.25 | [0.95–1.65] | 0.108 | 1.30 | [0.97–1.73] | 0.080 | 1.19 | [0.90–1.57] | 0.219 | - | - | - |
Malignancy in history |
0.72
|
[0.55–0.95]
|
0.018
| 0.79 | [0.59–1.05] | 0.109 | 1.20 | [0.82–1.78] | 0.352 | - | - | - | 1.29 | [0.98–1.71] | 0.123 | 1.12 | [0.97–1.29] | 0.420 |
Recent year of surgery |
1.39
|
[1.30–1.49]
|
<0.001
|
1.39
|
[1.29–1.49]
|
<0.001
| 0.91 | [0.83–1.00] | 0.060 |
0.89
|
[0.80–1.00]
*
|
0.047
| 0.97 | [0.91–1.04] | 0.393 | - | - | - |
Neoadjuvant treatment |
1.79
|
[1.49–2.15]
|
<0.001
|
1.41
|
[1.15–1.76]
|
0.001
| 0.94 | [0.72–1.23] | 0.663 | - | - | - |
0.63
|
[0.52–0.76]
|
<0.001
|
0.69
|
[0.55–0.85]
|
0.001
|
Total gastrectomy |
1.81
|
[1.49–2.20]
|
<0.001
|
1.46
|
[1.18–1.79]
|
<0.001
|
1.45
|
[1.10–1.91]
|
0.009
| 1.25 | [0.93–1.68] | 0.134 |
1.45
|
[1.19–1.75]
|
<0.001
|
1.54
|
[1.26–1.89]
|
<0.001
|
pT3-4 stage |
1.44
|
[1.20–1.72]
|
<0.001
|
1.26
|
[1.01–1.56]
|
0.038
|
8.52
|
[5.42–13.40]
|
<0.001
|
5.80
|
[3.61–9.31]
|
<0.001
|
2.95
|
[2.34–3.73]
|
<0.001
|
1.90
|
[1.47–2.44]
|
<0.001
|
pN+ stage |
1.50
|
[1.25–1.79]
|
<0.001
|
1.30
|
[1.06–1.60]
|
0.013
|
4.18
|
[3.04–5.75]
|
<0.001
|
2.10
|
[1.32–3.32]
|
<0.001
|
3.00
|
[2.42–3.71]
|
<0.001
|
2.29
|
[1.82–2.88]
|
<0.001
|
Poor differentiation |
1.42
|
[1.12–1.80]
|
<0.001
| 1.19 | [0.92–1.53] | 0.180 |
2.73
|
[1.75–4.26]
|
<0.001
|
2.01
|
[1.32–3.32]
|
0.002
|
1.38
|
[1.08–1.77]
|
<0.001
| 1.26 | [0.98–1.62] | 0.072 |