Comparative Outcomes of Laparoscopic Gastrectomy and Open Gastrectomy for Scirrhous Gastric Cancer: A Multicenter Retrospective Cohort Study

Yusuke Fujita, MD; Tatsuto Nishigori, MD, PhD; Yoshio Kadokawa, MD, PhD; Atsushi Itami, MD, PhD; Masato Kondo, MD; Hisahiro Hosogi, MD, PhD; Seiichiro Kanaya, MD, PhD; Hironori Kawada, MD, PhD; Hiroaki Hata, MD, PhD; Michihiro Yamamoto, MD; Yousuke Kinjo, MD, PhD; Eiji Tanaka, MD, PhD; Dai Manaka, MD, PhD; Seiji Satoh, MD, PhD; Hiroshi Okabe, MD, PhD; Shigeru Tsunoda, MD, PhD; Masazumi Sakaguchi, MD, PhD; Shigeo Hisamori, MD, PhD; Koya Hida, MD, PhD; Shiro Tanaka, PhD; Kazutaka Obama, MD, PhD; on behalf of Kyoto Esophageal and Gastric Surgery Study Group

doi:10.1097/AS9.0000000000000063

Annals of Surgery Open (Jun 2021)

Comparative Outcomes of Laparoscopic Gastrectomy and Open Gastrectomy for Scirrhous Gastric Cancer: A Multicenter Retrospective Cohort Study

Yusuke Fujita, MD,
Tatsuto Nishigori, MD, PhD,
Yoshio Kadokawa, MD, PhD,
Atsushi Itami, MD, PhD,
Masato Kondo, MD,
Hisahiro Hosogi, MD, PhD,
Seiichiro Kanaya, MD, PhD,
Hironori Kawada, MD, PhD,
Hiroaki Hata, MD, PhD,
Michihiro Yamamoto, MD,
Yousuke Kinjo, MD, PhD,
Eiji Tanaka, MD, PhD,
Dai Manaka, MD, PhD,
Seiji Satoh, MD, PhD,
Hiroshi Okabe, MD, PhD,
Shigeru Tsunoda, MD, PhD,
Masazumi Sakaguchi, MD, PhD,
Shigeo Hisamori, MD, PhD,
Koya Hida, MD, PhD,
Shiro Tanaka, PhD,
Kazutaka Obama, MD, PhD,
on behalf of Kyoto Esophageal and Gastric Surgery Study Group

Affiliations

Yusuke Fujita, MD: From the * Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Tatsuto Nishigori, MD, PhD: From the * Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Yoshio Kadokawa, MD, PhD: † Department of Gastrointestinal Surgery, Tenri Hospital, Tenri, Japan
Atsushi Itami, MD, PhD: ‡ Department of Surgery, Kobe City Nishi-Kobe Medical Center, Kobe, Japan
Masato Kondo, MD: § Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
Hisahiro Hosogi, MD, PhD: ‖ Department of Surgery, Osaka Red Cross Hospital, Osaka, Japan
Seiichiro Kanaya, MD, PhD: ‖ Department of Surgery, Osaka Red Cross Hospital, Osaka, Japan
Hironori Kawada, MD, PhD: ¶ Department of Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
Hiroaki Hata, MD, PhD: # Department of Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
Michihiro Yamamoto, MD: ** Department of Surgery, Shiga General Hospital, Moriyama, Japan
Yousuke Kinjo, MD, PhD: †† Department of Gastroenterological Surgery and Oncology, Himeji Medical Center, Himeji, Japan
Eiji Tanaka, MD, PhD: ‡‡ Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Japan
Dai Manaka, MD, PhD: §§ Department of Surgery, Kyoto Katsura Hospital, Kyoto, Japan
Seiji Satoh, MD, PhD: ‖‖ Department of Surgery, Kyoto City Hospital, Kyoto, Japan
Hiroshi Okabe, MD, PhD: ¶¶ Department of Surgery, Otsu City Hospital, Otsu, Japan
Shigeru Tsunoda, MD, PhD: From the * Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Masazumi Sakaguchi, MD, PhD: From the * Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Shigeo Hisamori, MD, PhD: From the * Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Koya Hida, MD, PhD: From the * Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
Shiro Tanaka, PhD: ## Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Kazutaka Obama, MD, PhD: From the * Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
on behalf of Kyoto Esophageal and Gastric Surgery Study Group

DOI: https://doi.org/10.1097/AS9.0000000000000063
Journal volume & issue: Vol. 2, no. 2
p. e063

Abstract

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Objective:. A multicenter retrospective cohort study was performed to compare the outcomes of laparoscopic gastrectomy (LG) versus open gastrectomy (OG) for scirrhous gastric cancer (GC) as a unique subtype also known as type 4 gastric cancer or linitis plastica. Background:. Although data on the efficacy and safety of LG as an alternative to OG are emerging, the applicability of LG to scirrhous GC remains unclear. Methods:. Patients with clinical type 4 GC undergoing gastrectomy at 13 hospitals from 2005 to 2015 were retrospectively reviewed. As the primary endpoint, we compared overall survival (OS) between the LG and OG groups. To adjust for confounding factors, we used multivariate Cox regression analysis for the main analyses and propensity-score matching for sensitivity analysis. Short-term outcomes and recurrence-free survival were also compared. Results:. A total of 288 patients (LG, 62; OG, 226) were included in the main analysis. Postoperative complications occurred in 25.8% and 30.1%, respectively (P = 0.44). No significant difference in recurrence-free survival was observed (P = 0.72). The 5-year OS rates were 32.4% and 31.6% in the LG and OG groups, respectively (P = 0.60). The hazard ratio (LG/OG) for OS was 0.98 (95% confidence interval [CI], 0.65–1.43) in the multivariate regression analysis. In the sensitivity analyses after propensity-score matching, the hazard ratio for OS was 0.92 (95% CI, 0.58–1.45). Conclusions:. Considering the hazard ratios and 95% CIs for OS, LG for scirrhous GC was not associated with worse survival than that for OG.

Published in Annals of Surgery Open

ISSN: 2691-3593 (Online)
Publisher: Wolters Kluwer Health
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://journals.lww.com/aosopen/pages/default.aspx

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