Researchers from Korea have reported that laparoscopy-assisted surgery for early gastric cancer results in a 98.8% three-year overall survival in patients with early gastric cancer. The details of this study appeared in the June 2009 issue of the Archives of Surgery.[1]

The primary treatment of gastric cancer is total or subtotal gastrectomy with removal of the lymph nodes to determine spread. These procedures are usually performed with “open” surgery, which is considered a major operative procedure. Laparoscopic gastrectomy, in contrast, is a minimally invasive surgical procedure during which a surgeon removes the stomach through a lighted tube. This type of procedure prevents the need for large surgical incisions and may reduce the risk of infection, healing complications, pain, and blood loss. Laparoscopic surgery is being evaluated for a wide variety of surgical conditions.

A recent study from the Memorial Sloan-Kettering Cancer Center reported that laparoscopic surgery produces a similar rate of recurrence-free survival to traditional open surgery in patients with gastric cancer with fewer complications and shorter hospital stays.

The current Korean study reported the outcomes of 178 subtotal and 19 total gastrectomies performed in patients with gastric cancer. One-hundred-fifty-two patients had limited lymphadenectomies performed, and 45 had extensive lymphadenectomies performed. One-hundred-seventy-three patients had early-stage gastric cancer, and 24 had advanced-stage gastric cancer. For the entire group, there were seven recurrences. On multivariate analyses the depth of invasion and metastases to lymph nodes affected outcome. For the 173 patients with early-stage gastric cancer, the three-year overall survival was 98.8% compared with 79.1% for patients with more advanced disease. These authors concluded: “Laparoscopy-assisted gastrectomy is acceptable oncologically in early gastric cancer if 3-year disease-free survival represents 5-year overall survival. Laparoscopy-assisted gastrectomy may also play an important role in the treatment of advanced gastric cancer.”

Comments: This study confirms that laparoscopy-assisted gastrectomy is an acceptable treatment for patients with gastric cancer and may significantly reduce morbidity without compromising survival.

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