[Feasibility and efficacy of laparoscopic treatment for advanced gastric cancer from LOC-A study]

With the progression of surgical techniques, laparoscopic equipment and treatment concepts, laparoscopic radical gastrectomy has been widely used in clinical practice. However, whether laparoscopic surgery can be used for the treatment of locally advanced gastric cancer is still controversial. Recent results from the Korean KLASS-02 study, the Japanese JCOG-0901 study, and the Chinese CLASS-01 study suggest that there is no significant difference in the short-term efficacy between laparoscopic surgery and open surgery in the treatment of locally advanced gastric cancer. The long-term results have not been published. The LOC-A study was a multicenter, large sample size retrospective analysis that enrolled 1948 laparoscopic and open surgery cases with stage II to III locally advanced gastric cancer in 8 Japanese hospitals between 2008 and 2014. As a result, after removal of confounding factors by propensity score matching (PSM), the analysis showed no significant difference in long-term efficacy between laparoscopic surgery and open surgery for locally advanced gastric cancer. However, some bias still remain after the bias-control. Therefore, due to insufficiency of the high-level evidence-based medical evidence, we believe that the all-round promotion of laparoscopic surgery of locally advanced gastric cancer is too early, nevertheless, we should also recognize that the minimally invasive treatment of gastric cancer is the current development trend, and we should be confident in laparoscopic treatment of locally advanced gastric cancer.