Risk factors of the recurrence after laparoscopic gastrectomy for gastric cancer.

Hideya Kashihara, Mitsuo Shimada, Kozo Yoshikawa, Jun Higashijima, Toshihiro Nakao, Masaaki Nishi, Chie Takasu. The department of surgery, the university of Tokushima

Background: Laparoscopic gastrectomy (LG) have shown good outcomes in early gastric cancer (GC). However, recurrent cases after LG are observed. The aim of this study is to analyze risk factors of recurrence after LG.

Methods: Study1: 431 patients with GC who underwent LG were enrolled (LG143, OG288). Propensity scores were estimated using logistic regression model with the dependent variables as odds of undergoing laparoscopic surgery and the independent variables as pathologic T, N, Stage and lymph node dissection. Disease-free survival (DFS) according to clinicopathological factors in LG and OG group were estimated by using the Kaplan-Meier method.

Study2: The risk factors of recurrence after LG were investigated by multivariate analysis.

Results: Study1: 143 patients who were performed LG and 288 patients who were performed OG were balanced to 57 pairs. The 5-year DFS rate in LG and OG were 91.4% and 95.8%, respectively (n.s.). In Stage IA, IB, IIA and IIB, 5-year DFS in LG and OG showed no significant differences.

Study2: In LG group (n=143), six recurrent cases were observed (Liver: 2, Peritoneum: 4). There were neither lymph node nor port-site recurrence after LG. In univariate analysis (5-year DFS), fN (+), ly (+) and v (+) were the prognostic factors. The independent risk factor for recurrence in LG was fN(+).

Conclusion: DFS in LG is comparable to that in OG. fN(+) is independent risk factor for recurrence after LG.

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