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Five-year Survival Outcomes Of Laparoscopy-assisted Vs Open Distal Gastrectomy For Advanced Gastric Cancer: The Jlssg0901 Randomized Clinical Trial.

Home
Research Domains
Biomedical And Clinical Sciences
Oncology And Carcinogenesis
Predictive And Prognostic Markers
Five-year Survival Outcomes Of Laparoscopy-assisted Vs Open Distal Gastrectomy For Advanced Gastric Cancer: The Jlssg0901 Randomized Clinical Trial.

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Five-Year Survival Outcomes of Laparoscopy-Assisted vs Open Distal Gastrectomy for Advanced Gastric Cancer: The JLSSG0901 Randomized Clinical Trial.

Tsuyoshi Etoh¹, Tetsuji Ohyama², Shinichi Sakuramoto³

¹Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Japan.

|March 15, 2023

View abstract on PubMed

Summary

This summary is machine-generated.

Laparoscopy-assisted distal gastrectomy (LADG) is noninferior to open distal gastrectomy (ODG) for locally advanced gastric cancer based on 5-year survival outcomes. This study supports LADG as a potential standard treatment option.

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Intraoperative Gastroscopy for Tumor Localization in Laparoscopic Surgery for Gastric Adenocarcinoma

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Area of Science:

Surgical Oncology
Gastrointestinal Surgery
Minimally Invasive Surgery

Background:

Evidence for laparoscopic gastrectomy in locally advanced gastric cancer is limited due to short follow-up periods in prior studies.
Robust data are needed to confirm the noninferiority of laparoscopic techniques compared to open surgery.

Purpose of the Study:

To compare 5-year survival outcomes between laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) for locally advanced gastric cancer.
To evaluate the noninferiority of LADG versus ODG with D2 lymph node dissection.

Main Methods:

A multicenter, prospective, randomized clinical trial involving 502 patients with gastric carcinoma.
Patients were randomized to either ODG or LADG groups, performed by qualified surgeons.

Primary endpoint was 5-year relapse-free survival; secondary endpoints included 5-year overall survival and safety.

Main Results:

No significant difference in severe postoperative complications between ODG (4.7%) and LADG (3.5%).
5-year relapse-free survival was 73.9% for ODG and 75.7% for LADG (HR 0.96, noninferiority P=0.03).
Overall survival also showed no significant difference between the groups (HR 0.83).

Conclusions:

Laparoscopy-assisted distal gastrectomy with D2 lymph node dissection is noninferior to open distal gastrectomy for locally advanced gastric cancer.
LADG demonstrates comparable long-term survival and safety, suggesting it can be a standard treatment.
This study provides robust 5-year follow-up data supporting the efficacy of minimally invasive approaches.