Long-term outcomes and survival of patients undergoing laparoscopy-assisted distal gastrectomy for gastric cancer

Background and Aim: Laparoscopic-assisted distal gastrectomy (LADG) has recently become an alternative treatment option for gastric cancer. Although LADG is safe and feasible in terms of short-term patient results and oncological outcomes, the long-term oncological efficacy of LADG has yet to be demonstrated. To that end, the long-term results and the survival of patients who underwent LADG are described in this study. We also evaluated the oncological safety of using this approach for the treatment of gastric cancer. Subjects and Methods: Between January 2006 and December 2009, 133 patients with lower-third gastric cancer underwent LADG performed by a single surgeon. The clinicopathologic characteristics, long-term survival, and relapse-free survival were estimated using the Kaplan-Meier method. Results: Postoperative morbidity occurred in 5.6% of the patients. One patient died within 30 days of undergoing the operation (0.8%). The median overall survival (OS) of patients who underwent LADG was 45.0 months (range, 1.0-69.0 months). The median follow-up period of all patients was 37.0 months (range, 1.0-69.0 months). The 3-year OS rates according to cancer stage were 94.8% at Stage I, 84.6% at stage II, and 50.0% at Stage III. The median OS in patients who had a recurrence and those who had not had a recurrence was 27.0 (6.0-62.0) and 45.0 (1.0-69.0) months, respectively. Conclusions: LADG with lymph node dissection for gastric cancer is a valuable procedure from technical and oncological perspectives with acceptable long-term outcomes. Therefore, LADG can be substituted for open distal gastrectomy with similar effectiveness.