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Sun-Hwi Hwang, MD; Do Joong Park, MD; Ye Seob Jee, MD; Min-Chan Kim, MD; Hyung-Ho Kim, MD; Hyuk-Joon Lee, MD; Han-Kwang Yang, MD; Kuhn Uk Lee, MD

Arch Surg. 2009;144(6):559-564.

Objective  To analyze 3-year actual disease-free survival after laparoscopy-assisted gastrectomy for gastric cancer on the assumption that 3-year disease-free survival may represent 5-year overall survival.

Design  Retrospective analysis.

Setting  Department of surgery of a university hospital.

Patients  A total of 197 patients who underwent laparoscopy-assisted gastrectomy for gastric cancer from May 1998 to September 2007 and who were followed up for more than 3 years.

Main Outcome Measures  Feasibility and long-term survival rate with survival analysis by the Kaplan-Meier method.

Results  Subtotal and total gastrectomies were performed in 178 and 19 patients, respectively. The scope of the lymph node dissections were D1 + β (n = 152) and D2 (n = 45). There were 153, 28, 8, 6, 1, and 1 patients in stages Ia, Ib, II, IIIa, IIIb, and IV, respectively. The median follow-up was 45 months (range, 1-113 months), and there were 7 recurrences. Multivariate analysis of disease-specific survival showed that depth of invasion and lymph node metastasis influenced the prognosis independently. The actual 3-year disease-free survival rate for all patients was 96.9%. The 173 patients with early gastric cancer and 24 with advanced gastric cancer showed 98.8% and 79.1% actual 3-year disease-free survival rates, respectively.

Conclusions  Laparoscopy-assisted gastrectomy is acceptable oncologically in early gastric cancer if 3-year disease-free survival represents 5-year overall survival. Laparoscopy-assisted gastrectomy may also play an important role in the treatment of advanced gastric cancer.

Author Affiliations: Departments of Surgery, Seoul National University Bundang Hospital, Gyeonggi (Drs Hwang, Park, Jee, and H.-H. Kim), Seoul National University College of Medicine, Seoul (Drs H.-H. Kim, H.-J. Lee, Yang, and K. U. Lee), and Dong-A University College of Medicine, Busan (Dr M.-C. Kim); and Cancer Research Institute, Seoul National University College of Medicine (Drs H.-J. Lee and Yang), Korea.

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