Shinya Tanimura, MD, Toshiharu Yamaguchi, MD, Masayuki Higashino, MD
Cancer Institute Hospital
As less-invasive operations are noted in recent years, laparoscopic gastrectomy for gastric cancer tends to increase explosively in Japan and other Eastern Asian Countries. We have performed laparoscopic gastrectomy with regional lymph node dissection on 1082 cases of gastric malignancies between March 1998 and August 2012. Here we present the outcome of laparoscopic gastrectomy for gastric cancer.
Of the 1082 cases, distal gastrectomy was performed on 824 cases, proximal gastrectomy on 52 cases, and total gastrectomy on 206 cases, respectively. The indication of laparoscopic operation was established sT2N1 or less. D1 lymph node dissection for T1 cases (n=753) or D2 for T2 or over T2 cases (n=329) was carried out according to the general rule of Japanese Gastric Cancer Association.
The final stages of the patients were as follows; stage IA: 703, stage IB: 120, stage IIA: 86, stage IIB: 74, stage IIIA: 40, stage IIIB: 29 and stage IIIC: 30. Recurrence occurred in 65 cases (T1: 6, T2: 59). The cumulative 5 year survival rate of all cases was 93.5%. The outcome in each stage was as follows; stage IA: 99.5%, stage IB: 98.2%, stage IIA: 90.9%, stage IIB: 79.9%, stage IIIA: 57.3%, stage IIIB: 68.0% and stage IIIC: 41.5%, respectively. There was no significant difference between the prognosis of laparoscopic and open gastrectomy patients.
In conclusion, laparoscopic gastrectomy for gastric cancer is considered as curative as compared to the conventional open gastrectomy.
Program Number: P011