Assessment of Open Versus Laparoscopy-Assisted Gastrectomy in Lymph Node-Positive Early Gastric Cancer: A Retrospective Cohort Analysis

Background: Laparoscopy-assisted gastrectomy (LAG) is still limited for early gastric cancer (EGC) with low possibility of lymph node (LN) metastasis, due to the concern for incomplete LN dissection and controversial long-term outcomes We assessed oncological outcomes of laparoscopy-assisted versus open gastrectomy (0G) for patients with LN positive EGC Methods: Between 2003 and 2007. 204 patients underwent surgery for LN positive EGC We evaluated adequacy of LN dissection and early and long-term outcomes after OG (n = 162) and LAG (n = 42) Results: Operative time was longer but hospital stay was shottei for LAG than OG Postoperative complications occurred in 14 patients (8 6%) after OG and 1 patient (2 4%) after LAG (P = 0 316) Mean number of retrieved LNs and number of retrieved and metastatic LNs for each station did not differ between the two groups Durint! median 35 months of follow-up, 14 patients (8 6r,) developed recurrence after OG, compared with 4 patients (9 5%) after LAG (P = 0 769) Overall 5-year disease-free survival was 89 9% and 89 7% after OG and LAG Status of LN metastasis was the only independent pto2nostic factor for disease-free survival Conclusions: LAG is an oncoloizically safe procedure even for LN positive EGC Adequate LN dissection and comparable long-term outcomes to OG can be achieved by LAG J Slug Oncol 2010.102 77-81 2010 Wiley-Liss, Inc