Morbidity and mortality after laparoscopic gastrectomy for advanced gastric cancer: Results of a phase II clinical trial

Ju Hee Lee, Sang Yong Son, Chang Min Lee, Sang Hoon Ahn, Do Joong Park, Hyung Ho Kim

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Very few reports are available on laparoscopic gastrectomy (LG) for advanced gastric cancer (AGC) patients. We therefore conducted a prospective phase II clinical trial to address the feasibility of LG in AGC. Morbidity and mortality were evaluated. Methods: The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN2, American Society of Anesthesiologists score of 3 or less, and no other malignancy. A total of 204 patients were enrolled onto this study. Of these, 16 were excluded because far-advanced stages of disease were identified after laparoscopic exploration, and 31 were excluded because early gastric cancer was diagnosed postoperatively. All patients underwent a D2 lymphadenectomy. Morbidity was stratified according to the Clavien-Dindo classification. Results: Conversion to open surgery occurred in 11 patients (7.0 %). The mean hospital stay was 6.3 days for distal gastrectomy and 8.5 days for total gastrectomy. The mean number of collected lymph nodes was 52.7 for distal gastrectomy and 63.8 for total gastrectomy. The rates of local and systemic complications of grade II or more were 8.3 and 3.2 %. One patient died of operative complications. In multivariate analysis, old age (>70 years) was an independent risk factor for complications, and old age and Billroth I anastomosis were predictable risk factors for local complications. Conclusions: LG with D2 lymphadenectomy was safe and technically feasible for the treatment of AGC, with acceptable rate of morbidity and mortality. ClinicalTrial.gov Registration: NCT01441336.

Original languageEnglish
Pages (from-to)2877-2885
Number of pages9
JournalSurgical Endoscopy
Volume27
Issue number8
DOIs
Publication statusPublished - 2013 Jan 1
Externally publishedYes

Fingerprint

Phase II Clinical Trials
Gastrectomy
Stomach Neoplasms
Morbidity
Mortality
Lymph Node Excision
Conversion to Open Surgery
Gastroenterostomy
Length of Stay
Multivariate Analysis
Lymph Nodes

Keywords

  • Advanced gastric cancer
  • Laparoscopic gastrectomy
  • Morbidity
  • Short-term outcomes

ASJC Scopus subject areas

  • Surgery

Cite this

Morbidity and mortality after laparoscopic gastrectomy for advanced gastric cancer : Results of a phase II clinical trial. / Lee, Ju Hee; Son, Sang Yong; Lee, Chang Min; Ahn, Sang Hoon; Park, Do Joong; Kim, Hyung Ho.

In: Surgical Endoscopy, Vol. 27, No. 8, 01.01.2013, p. 2877-2885.

Research output: Contribution to journalArticle

Lee, Ju Hee ; Son, Sang Yong ; Lee, Chang Min ; Ahn, Sang Hoon ; Park, Do Joong ; Kim, Hyung Ho. / Morbidity and mortality after laparoscopic gastrectomy for advanced gastric cancer : Results of a phase II clinical trial. In: Surgical Endoscopy. 2013 ; Vol. 27, No. 8. pp. 2877-2885.
@article{cbe876395c9c485a9c373ff5fd272c8b,
title = "Morbidity and mortality after laparoscopic gastrectomy for advanced gastric cancer: Results of a phase II clinical trial",
abstract = "Background: Very few reports are available on laparoscopic gastrectomy (LG) for advanced gastric cancer (AGC) patients. We therefore conducted a prospective phase II clinical trial to address the feasibility of LG in AGC. Morbidity and mortality were evaluated. Methods: The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN2, American Society of Anesthesiologists score of 3 or less, and no other malignancy. A total of 204 patients were enrolled onto this study. Of these, 16 were excluded because far-advanced stages of disease were identified after laparoscopic exploration, and 31 were excluded because early gastric cancer was diagnosed postoperatively. All patients underwent a D2 lymphadenectomy. Morbidity was stratified according to the Clavien-Dindo classification. Results: Conversion to open surgery occurred in 11 patients (7.0 {\%}). The mean hospital stay was 6.3 days for distal gastrectomy and 8.5 days for total gastrectomy. The mean number of collected lymph nodes was 52.7 for distal gastrectomy and 63.8 for total gastrectomy. The rates of local and systemic complications of grade II or more were 8.3 and 3.2 {\%}. One patient died of operative complications. In multivariate analysis, old age (>70 years) was an independent risk factor for complications, and old age and Billroth I anastomosis were predictable risk factors for local complications. Conclusions: LG with D2 lymphadenectomy was safe and technically feasible for the treatment of AGC, with acceptable rate of morbidity and mortality. ClinicalTrial.gov Registration: NCT01441336.",
keywords = "Advanced gastric cancer, Laparoscopic gastrectomy, Morbidity, Short-term outcomes",
author = "Lee, {Ju Hee} and Son, {Sang Yong} and Lee, {Chang Min} and Ahn, {Sang Hoon} and Park, {Do Joong} and Kim, {Hyung Ho}",
year = "2013",
month = "1",
day = "1",
doi = "10.1007/s00464-013-2848-0",
language = "English",
volume = "27",
pages = "2877--2885",
journal = "Surgical Endoscopy",
issn = "0930-2794",
publisher = "Springer New York",
number = "8",

}

TY - JOUR

T1 - Morbidity and mortality after laparoscopic gastrectomy for advanced gastric cancer

T2 - Results of a phase II clinical trial

AU - Lee, Ju Hee

AU - Son, Sang Yong

AU - Lee, Chang Min

AU - Ahn, Sang Hoon

AU - Park, Do Joong

AU - Kim, Hyung Ho

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Background: Very few reports are available on laparoscopic gastrectomy (LG) for advanced gastric cancer (AGC) patients. We therefore conducted a prospective phase II clinical trial to address the feasibility of LG in AGC. Morbidity and mortality were evaluated. Methods: The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN2, American Society of Anesthesiologists score of 3 or less, and no other malignancy. A total of 204 patients were enrolled onto this study. Of these, 16 were excluded because far-advanced stages of disease were identified after laparoscopic exploration, and 31 were excluded because early gastric cancer was diagnosed postoperatively. All patients underwent a D2 lymphadenectomy. Morbidity was stratified according to the Clavien-Dindo classification. Results: Conversion to open surgery occurred in 11 patients (7.0 %). The mean hospital stay was 6.3 days for distal gastrectomy and 8.5 days for total gastrectomy. The mean number of collected lymph nodes was 52.7 for distal gastrectomy and 63.8 for total gastrectomy. The rates of local and systemic complications of grade II or more were 8.3 and 3.2 %. One patient died of operative complications. In multivariate analysis, old age (>70 years) was an independent risk factor for complications, and old age and Billroth I anastomosis were predictable risk factors for local complications. Conclusions: LG with D2 lymphadenectomy was safe and technically feasible for the treatment of AGC, with acceptable rate of morbidity and mortality. ClinicalTrial.gov Registration: NCT01441336.

AB - Background: Very few reports are available on laparoscopic gastrectomy (LG) for advanced gastric cancer (AGC) patients. We therefore conducted a prospective phase II clinical trial to address the feasibility of LG in AGC. Morbidity and mortality were evaluated. Methods: The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN2, American Society of Anesthesiologists score of 3 or less, and no other malignancy. A total of 204 patients were enrolled onto this study. Of these, 16 were excluded because far-advanced stages of disease were identified after laparoscopic exploration, and 31 were excluded because early gastric cancer was diagnosed postoperatively. All patients underwent a D2 lymphadenectomy. Morbidity was stratified according to the Clavien-Dindo classification. Results: Conversion to open surgery occurred in 11 patients (7.0 %). The mean hospital stay was 6.3 days for distal gastrectomy and 8.5 days for total gastrectomy. The mean number of collected lymph nodes was 52.7 for distal gastrectomy and 63.8 for total gastrectomy. The rates of local and systemic complications of grade II or more were 8.3 and 3.2 %. One patient died of operative complications. In multivariate analysis, old age (>70 years) was an independent risk factor for complications, and old age and Billroth I anastomosis were predictable risk factors for local complications. Conclusions: LG with D2 lymphadenectomy was safe and technically feasible for the treatment of AGC, with acceptable rate of morbidity and mortality. ClinicalTrial.gov Registration: NCT01441336.

KW - Advanced gastric cancer

KW - Laparoscopic gastrectomy

KW - Morbidity

KW - Short-term outcomes

UR - http://www.scopus.com/inward/record.url?scp=84881369381&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881369381&partnerID=8YFLogxK

U2 - 10.1007/s00464-013-2848-0

DO - 10.1007/s00464-013-2848-0

M3 - Article

C2 - 23404155

AN - SCOPUS:84881369381

VL - 27

SP - 2877

EP - 2885

JO - Surgical Endoscopy

JF - Surgical Endoscopy

SN - 0930-2794

IS - 8

ER -