Laparoscopic gastrectomy and metastasectomy for stage IV gastric cancer

Sa Hong Min, Yongjoon Won, Kanghaeng Lee, Sang Il Youn, Guowei Kim, Young Suk Park, Sang Hoon Ahn, Do Joong Park, Hyung Ho Kim

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: The standard recommended treatment of stage IV gastric cancer is palliative chemotherapy. The aim of this study is to evaluate the role of radical gastrectomy with metastasectomy in these patients, as well as to explore the feasibility and safety of a laparoscopic approach. Methods: 117 consecutive patients with pathologically proven Stage IV gastric cancer who underwent radical gastrectomy with metastasectomy were enrolled in this study. We evaluated short-term and long-term outcomes, comparing laparoscopic surgery with open surgery by propensity score matching. Results: The 5-year overall survival rate (OSR) was 23.2% and the median survival time (MST) was 19.8 months. After propensity scoring matching, the 5-year OSR and MST of laparoscopy group was 23.4%, 17.9 months and in the open group, it was 25.0%, 22.8 months (p = 0.882). The complication rate was 5.6% in the laparoscopy group and 23.4% in the open group (p = 0.069). In multivariate analysis, adjuvant chemotherapy, chemotherapy cycle, and postoperative complication were independent prognostic factors of overall survival. Conclusions: Radical gastrectomy with metastasectomy could have a potential role in stage IV gastric cancer. Laparoscopic gastrectomy with metastasectomy in selected stage IV gastric cancer patients is safe and feasible.

Original languageEnglish
Pages (from-to)1879-1887
Number of pages9
JournalSurgical Endoscopy
Volume35
Issue number4
DOIs
StatePublished - Apr 2021

Keywords

  • Advanced gastric cancer
  • Gastrectomy
  • Laparoscopy
  • Metastasis
  • Survival

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