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Long-Term Outcomes of Laparoscopic Radical Gastrectomy for Highly Advanced Gastric Cancer: Final Report of a Prospective Phase II Trial (KUGC04)

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This is the final report evaluating the long-term outcomes of a single-arm phase II clinical trial that demonstrated the short-term efficacy of laparoscopic gastrectomy (LG) for highly advanced gastric cancer (AGC) [KUGC04].

Patients and Methods

Seventy-three patients with histologically confirmed gastric adenocarcinoma and diagnosed with clinical stage II or higher, who potentially underwent curative resection between August 2009 and November 2014, were prospectively enrolled. Long-term outcomes with 5-year progression-free survival (PFS) and 5-year overall survival (OS) were evaluated according to clinical or pathological stages. Recurrence and progression patterns were also investigated. These outcomes were compared with those of previous reports to assess the applicability of LG for highly advanced gastric cancer (HAGC).

Results

The median observation period of all surviving patients was 75.1 months. The 5-year PFS and 5-year OS of all patients was 47.4% and 54.4%, respectively. Clinical stage-specific 5-year PFS and 5-year OS was 75.0, 69.1, 53.9, 39.4, 40.0 and 9.1, and 75.0, 68.8, 61.5, 45.0, 60.0 and 27.3, respectively, in stages IIA, IIB, IIIA, IIIB, IIIC, and IV, respectively. Pathological stage-specific 5-year PFS and 5-year OS, including ypStage with preoperative chemotherapy, was 100, 80.0, 100, 62.5, 80.0, 51.3, 16.7, 22.2 and 12.5, and 100, 80.0, 100, 75.0, 80.0, 64.2, 25.0, 33.3 and 12.5, respectively, in stage X (no residual tumor with preoperative chemotherapy), IA, IB, IIA, IIB, IIIA, IIIB, IIIC, and IV, respectively. Recurrence or progression was observed in 30 patients (41.1%).

Conclusion

LG for HAGC performed by experienced surgeons is safe and oncologically acceptable.

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Funding

No funding was received for this study.

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Author notes

  1. Shigeo Hisamori and Hiroshi Okabe contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Shigeo Hisamori MD, PhD, Hiroshi Okabe MD, PhD, Shigeru Tsunoda MD, PhD, Tatsuto Nishigori MD, PhD, Riki Ganeko MD, Yudai Fukui MD, Ryosuke Okamura MD, PhD, Hisatsugu Maekawa MD, PhD, Yoshiharu Sakai MD, PhD & Kazutaka Obama MD, PhD

  2. Department of Gastroenterological Surgery, New Tokyo Hospital, Matsudo, Japan

    Hiroshi Okabe MD, PhD

  3. Department of Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan

    Yoshiharu Sakai MD, PhD

Authors
  1. Shigeo Hisamori MD, PhD
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  2. Hiroshi Okabe MD, PhD
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  3. Shigeru Tsunoda MD, PhD
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  4. Tatsuto Nishigori MD, PhD
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  7. Ryosuke Okamura MD, PhD
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  8. Hisatsugu Maekawa MD, PhD
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  9. Yoshiharu Sakai MD, PhD
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  10. Kazutaka Obama MD, PhD
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Corresponding author

Correspondence to Shigeo Hisamori MD, PhD.

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Dislosure

Shigeo Hisamori, Hiroshi Okabe, Shigeru Tsunoda, Tatsuto Nishigori, Riki Ganeko, Yudai Fukui, Ryosuke Okamura, Hisatsugu Maekawa, Yoshiharu Sakai, and Kazutaka Obama declare they have no conflicts of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

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Informed consent to be included in the study or equivalent was obtained from all patients.

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Hisamori, S., Okabe, H., Tsunoda, S. et al. Long-Term Outcomes of Laparoscopic Radical Gastrectomy for Highly Advanced Gastric Cancer: Final Report of a Prospective Phase II Trial (KUGC04). Ann Surg Oncol 28, 8962–8972 (2021). https://doi.org/10.1245/s10434-021-10373-8

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