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Long-Term Survival Outcomes Support Laparoscopic Distal Gastrectomy for Gastric Cancer
Laparoscopic gastrectomy for gastric cancer is increasingly being adopted globally based on clinical trials demonstrating equivalent oncologic outcomes compared with open gastrectomy and potential reduction in operative morbidity, both in early-stage and more locally advanced gastric cancer.
Investigators in China now report 5-year survival results from the CLASS-01 trial in which 1056 patients with locally advanced gastric cancer were randomized to open or laparoscopic distal gastrectomy with D2 lymphadenectomy. The two arms were balanced in mean age (57–56), pathologic stage (II, 26%–27%; III, 42%–43%; N0, 41%–42%), and receipt of adjuvant chemotherapy (37%–42%).
Rates of 5-year overall survival were similar in the laparoscopic and open distal gastrectomy groups (72.6% and 76.3%; hazard ratio, 1.17; P=0.19). The risk of gastric cancer–related death also did not differ significantly between groups (HR, 1.14; P=0.34). There were no significant differences between groups in survival outcome by cancer stage.
Comment
Accumulating evidence continues to support the use of laparoscopic gastrectomy with D2 lymphadenectomy both in early-stage and more locally advanced gastric cancers. This surgical approach remains underutilized in Western countries.
Citation(s)
Author:
Huang C et al.
Title:
Laparoscopic vs open distal gastrectomy for locally advanced gastric cancer: Five-year outcomes from the CLASS-01 randomized clinical trial.
Source:
JAMA Surg
2021
Oct
20; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
David H. Ilson, MD, PhD