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Patient-Reported Outcomes of Individuals with Gastric Cancer Undergoing Totally Laparoscopic Versus Laparoscopic-Assisted Total Gastrectomy: A Real-World, Propensity Score-Matching Analysis

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

Abstract

Objective

Totally laparoscopic total gastrectomy (TLTG) and laparoscopic-assisted total gastrectomy (LATG) are two types of minimally invasive radical gastrectomy procedures to treat gastric cancer (GC). This study compared the long-term prognosis and postoperative health-related quality of life (HRQoL) between TLTG and LATG.

Methods

A total of 106 patients who underwent TLTG and 1,076 patients who underwent LATG at the Union Hospital of Fujian Medical University (Fuzhou, China) between January 2014 and April 2018 were included in the propensity score matching (PSM, 1:2). Patient-reported outcomes at 3, 6, and 12 months after gastrectomy were analyzed. The questionnaire referred to the European Organization for Research and Treatment of Cancer (EORTC) 30-item core QoL (QLQ-C30)and the GC module (QLQ-STO22) questionnaire.

Results

After PSM, there were no significant differences in clinicopathological characteristics between the TLTG (n = 104) and the LATG groups (n = 208). Operative time and volume of blood loss were significantly lower in the TLTG group than in the LATG group. Kaplan-Meier survival analysis revealed similar 3-year survival rates between the TLTG and LATG groups (83.7 vs. 80.3%, respectively; P = 0.462). Tolerance to nonliquid diet, decrease in body weight, and albumin levels were also significantly lower in the TLTG group than in the LATG group (all P < 0.05). The HRQoL scale demonstrated that the overall score in the TLTG group was better than that in the LATG group at 3, 6, and 12 months after gastrectomy (all P < 0.05).

Conclusions

Patients with GC undergoing TLTG reported better HRQoL and experienced faster recovery of social function than those undergoing LATG, although the two groups demonstrated similar short-term outcomes and long-term prognosis.

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Acknowledgment

The authors thank those who have devoted a lot to this study, including nurses, pathologists, further-study doctors, statisticians, reviewers, and editors. They also thank Editage (www.editage.cn) for English language editing and Jia-**ang Yang for eFigure 1 drawing. They were not financially compensated for their contributions.

Funding

No funding was received for this study.

Author information

Author notes

  1. Guang-Tan Lin, Jun-Yu Chen, and Qi-Yue Chen have contributed equally to this work and co first authors.

Authors and Affiliations

  1. Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Guang-Tan Lin MD, Jun-Yu Chen MD, Qi-Yue Chen MD, PhD, Si-** Que MD, Zhi-Yu Liu MD, Qing Zhong MD, Jia-Bin Wang MD, PhD, Jian-**an Lin MD, PhD, Jun Lu MD, PhD, Mi Lin MD, Ze-Ning Huang MD, Jian-Wei **e MD, PhD, ** Li MD, PhD, Chang-Ming Huang MD & Chao-Hui Zheng MD, PhD

  2. Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Guang-Tan Lin MD, Jun-Yu Chen MD, Qi-Yue Chen MD, PhD, Si-** Que MD, Zhi-Yu Liu MD, Qing Zhong MD, Jia-Bin Wang MD, PhD, Jian-**an Lin MD, PhD, Jun Lu MD, PhD, Mi Lin MD, Ze-Ning Huang MD, Jian-Wei **e MD, PhD, ** Li MD, PhD, Chang-Ming Huang MD & Chao-Hui Zheng MD, PhD

  3. Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, Fuzhou, China

    Guang-Tan Lin MD, Jun-Yu Chen MD, Qi-Yue Chen MD, PhD, Si-** Que MD, Zhi-Yu Liu MD, Qing Zhong MD, Jia-Bin Wang MD, PhD, Jian-**an Lin MD, PhD, Jun Lu MD, PhD, Mi Lin MD, Ze-Ning Huang MD, Jian-Wei **e MD, PhD, ** Li MD, PhD, Chang-Ming Huang MD & Chao-Hui Zheng MD, PhD

  4. Fujian Key Laboratory of Tumor Microbiology, Department of Medical Microbiology, Fujian Medical University, Fuzhou, China

    Guang-Tan Lin MD, Jun-Yu Chen MD, Qi-Yue Chen MD, PhD, Si-** Que MD, Zhi-Yu Liu MD, Qing Zhong MD, Jia-Bin Wang MD, PhD, Jian-**an Lin MD, PhD, Jun Lu MD, PhD, Mi Lin MD, Ze-Ning Huang MD, Jian-Wei **e MD, PhD, ** Li MD, PhD, Chang-Ming Huang MD & Chao-Hui Zheng MD, PhD

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  1. Guang-Tan Lin MD
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Contributions

Guang-Tan Lin, Jun-Yu Chen, and Qi-Yue Chen conceived the study, analyzed the data, and drafted the manuscript. Chao-Hui Zheng and Chang-Ming Huang helped critically revise the manuscript for important intellectual content. Si-** Que, Zhi-Yu Liu, Qing Zhong, Jia-Bin Wang, Jian-**an Lin, Jun Lu, Long-Long Cao, Mi Lin, Ru-Hong Tu, Ze-Ning Huang, Ju-Li Lin, Hua-Long Zheng, Jian-Wei **e, and ** Li helped collect data and design the study.

Corresponding author

Correspondence to Chao-Hui Zheng MD, PhD.

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Lin, GT., Chen, JY., Chen, QY. et al. Patient-Reported Outcomes of Individuals with Gastric Cancer Undergoing Totally Laparoscopic Versus Laparoscopic-Assisted Total Gastrectomy: A Real-World, Propensity Score-Matching Analysis. Ann Surg Oncol 30, 1759–1769 (2023). https://doi.org/10.1245/s10434-022-12764-x

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