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Recurrence following laparoscopy-assisted gastrectomy for gastric cancer: a multicenter retrospective analysis of 1,417 patients

Authors
 Jyewon Song  ;  Hyuk-Joon Lee  ;  Gyu Seok Cho  ;  Sang-Uk Han  ;  Min-Chan Kim  ;  Seung Wan Ryu  ;  Wook Kim  ;  Kyo Young Song  ;  Hyung-Ho Kim  ;  Woo Jin Hyung 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.17(7) : 1777-1786, 2010 
Journal Title
ANNALS OF SURGICAL ONCOLOGY
ISSN
 1068-9265 
Issue Date
2010
MeSH
Adenocarcinoma/diagnosis* ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Disease Progression ; Female ; Follow-Up Studies ; Gastrectomy* ; Humans ; Laparoscopy* ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis* ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/diagnosis* ; Stomach Neoplasms/surgery ; Young Adult
Keywords
Gastric Cancer ; Early Gastric Cancer ; Advanced Gastric Cancer ; Locoregional Recurrence ; Laparoscopic Gastrectomy
Abstract
BACKGROUND: The risk of recurrence and recurrence patterns after laparoscopy-assisted gastrectomy for gastric cancer remain unclear. The objective of this study is to assess recurrence and its timing, patterns, and risk factors following laparoscopy-assisted gastrectomy from multicenter data. METHODS: A retrospective multicenter study was performed using data from 1,485 patients who had undergone laparoscopy-assisted gastrectomy for gastric cancer at ten institutions from 1998 to 2005. Recurrence and its timing and patterns were reviewed. Univariate and multivariate analyses were performed to identify risk factors for recurrence. RESULTS: Excluding 68 patients (9 postoperative mortalities, 1 synchronous distant metastasis, 2 nonadenocarcinomas, and 56 losses to follow-up), 50 of 1,417 patients (3.5%) had recurrences. Incidence of recurrence was 1.6% (19/1186) in early gastric cancer and 13.4% (31/231) in advanced gastric cancer. Recurrence occurred in 34 of 50 patients (68.0%) within 2 years of surgery, and in 45 of 50 patients (90.0%) within 3 years. The recurrence pattern was hematogenous in 17 patients (34.0%), peritoneal in 11 (22.0%), locoregional in 10 (20.0%), distant lymph nodes in 2 (4.0%), and mixed in 10 (20.0%). Advanced T-classification and lymph node metastases were risk factors for recurrence. CONCLUSIONS: Laparoscopy-assisted gastrectomy showed satisfactory long-term oncologic outcomes similar to those of open surgery. The study provides additional evidence suggesting that laparoscopy-assisted gastrectomy is a good alternative to open gastrectomy in patients with gastric cancer of relatively early stage, although results of a randomized controlled trial and more long-term follow-up are needed to provide conclusive evidence.
Full Text
http://link.springer.com/article/10.1245%2Fs10434-010-0932-4
DOI
10.1245/s10434-010-0932-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Song, Jye Won(송재원)
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101463
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