Survival and surgical outcomes after laparoscopy-assisted total gastrectomy for gastric cancer: case-control study

Few results regarding the long-term survival from laparoscopy-assisted total gastrectomy (LATG) have been reported. The purpose of this study was to investigate the feasibility of LATG in terms of long-term survival and morbidity. A case-control study was conducted on 100 cases of LATG and 348 cases of open total gastrectomy (OTG) performed for treating clinical stage I (cT1N0, cT1N1, and cT2N0) gastric cancer from August 2003 to December 2008 at the National Cancer Center of Korea. The clinicopathological characteristics, surgical outcomes, and complications were compared between the LATG and OTG groups. The overall survival rate and disease-free survival rate were analyzed using a Cox proportional hazards model for multivariate analysis. The rate of postoperative complications was 27 %, the most common being anastomotic stenosis from LATG (9 %). There were no significant differences in surgical outcomes and complications between the LATG and OTG groups except for a longer operating time for LATG. Survival rates were also similar between groups; the hazard ratio of LATG versus OTG was 0.43 (95 % confidence interval [CI] = 0.15-1.20; p = 0.107) for overall survival and 0.47 (95 % CI = 0.19-1.18; p = 0.106) for disease-free survival. LATG may be a feasible procedure with acceptable complications and long-term survival rate for clinical stage I gastric cancer.