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Title: Comparative Outcomes of Laparoscopic Gastrectomy and Open Gastrectomy for Scirrhous Gastric Cancer: A Multicenter Retrospective Cohort Study
Authors: Fujita, Yusuke
Nishigori, Tatsuto
Kadokawa, Yoshio
Itami, Atsushi
Kondo, Masato
Hosogi, Hisahiro
Kanaya, Seiichiro
Kawada, Hironori
Hata, Hiroaki
Yamamoto, Michihiro
Kinjo, Yousuke
Tanaka, Eiji
Manaka, Dai
Satoh, Seiji
Okabe, Hiroshi
Tsunoda, Shigeru
Sakaguchi, Masazumi
Hisamori, Shigeo
Hida, Koya
Tanaka, Shiro
Obama, Kazutaka
Author's alias: 藤田, 悠介
錦織, 達人
角田, 茂
坂口, 正純
久森, 重夫
肥田, 侯矢
田中, 司朗
小濵, 和貴
Issue Date: Jun-2021
Publisher: Wolters Kluwer
Journal title: Annals of Surgery Open
Volume: 2
Issue: 2
Thesis number: e063
Abstract: Objective: A multicenter retrospective cohort study was performed to compare the outcomes of laparoscopic gastrectomy (LG) versus open gastrectomy (OG) for scirrhous gastric cancer (GC) as a unique subtype also known as type 4 gastric cancer or linitis plastica. Background: Although data on the efficacy and safety of LG as an alternative to OG are emerging, the applicability of LG to scirrhous GC remains unclear. Methods: Patients with clinical type 4 GC undergoing gastrectomy at 13 hospitals from 2005 to 2015 were retrospectively reviewed. As the primary endpoint, we compared overall survival (OS) between the LG and OG groups. To adjust for confounding factors, we used multivariate Cox regression analysis for the main analyses and propensity-score matching for sensitivity analysis. Short-term outcomes and recurrence-free survival were also compared. Results: A total of 288 patients (LG, 62; OG, 226) were included in the main analysis. Postoperative complications occurred in 25.8% and 30.1%, respectively (P = 0.44). No significant difference in recurrence-free survival was observed (P = 0.72). The 5-year OS rates were 32.4% and 31.6% in the LG and OG groups, respectively (P = 0.60). The hazard ratio (LG/OG) for OS was 0.98 (95% confidence interval [CI], 0.65–1.43) in the multivariate regression analysis. In the sensitivity analyses after propensity-score matching, the hazard ratio for OS was 0.92 (95% CI, 0.58–1.45). Conclusions: Considering the hazard ratios and 95% CIs for OS, LG for scirrhous GC was not associated with worse survival than that for OG.
Rights: © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
DOI(Published Version): 10.1097/as9.0000000000000063
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