Perioperative Outcomes in Open Versus Minimally Invasive Gastrectomy For Gastric Cancer: A European Multicenter Study...

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Minimally Invasive Surgery

Background:

• Limited real-world European data exists comparing minimally invasive (MIG) versus open gastrectomy (OG).
• Gastric cancer (GC) treatment outcomes require further investigation in diverse populations.

Purpose of the Study:

• To compare morbidity and mortality between MIG and OG for gastric cancer (GC).
• To conduct a subgroup analysis of total versus subtotal gastrectomy outcomes.

Main Methods:

• Retrospective analysis of 2430 GC patients from 24 European centers (2017-2021).
• Primary outcome: perioperative complication rate.
• Propensity score matching (PSM) to control for confounders.

Main Results:

• MIG associated with higher R0 resection rates, shorter hospital stay, and lower perioperative complications (23.0% vs. 31.6%).
• MIG showed reduced 30-day (1.6% vs. 3.3%) and 90-day (1.9% vs. 4.7%) mortality.
• Fewer complications with MIG in subtotal gastrectomy (17.9% vs. 25.3%), but not total gastrectomy (31.5% vs. 36.1%) post-PSM.

Conclusions:

• Minimally invasive subtotal gastrectomy is linked to fewer perioperative complications compared to open surgery.
• No significant difference in complications was observed for minimally invasive total gastrectomy versus open total gastrectomy.
• Minimally invasive subtotal gastrectomy is a viable option in specialized European centers.