Is All Advanced XXXX Suitable for Laparoscopy-Assisted Gastrectomy With Extended Lymphadenectomy? A Case-Control Study Using a Propensity Score Method.

@entity1 @entity1600 @entity356
BACKGROUND: The oncologic outcomes of laparoscopy-assisted gastrectomy (LAG) for the treatment of @entity1 with local advanced @entity356 (AGC) have not been evaluated. This study aimed to validate the oncologic efficacy of LAG for AGC. METHODS: The data from 539 @entity1 who underwent LAG and 539 @entity1 treated with open gastrectomy (OG) were selected using the propensity score-matching method from a database prospectively constructed between 2005 and 2011. The therapeutic value of @entity1600 ( @entity1600 ) dissection and the long-term surgical outcomes of these matched groups were compared. RESULTS: The groups were well balanced after the propensity score matched. The LAG and OG groups did not differ significantly in terms of clinicopathologic characteristics. The number of dissected LNs at stations 11 and 12a were significantly higher in the LAG group. However, the therapeutic index at each @entity1600 station did not differ significantly between the two groups. Although the overall survival curve at each stage did not differ significantly (P  >  0.05), the survival rate increased overall for @entity1 with pT4aN3bM0 in the OG group (P  <  0.05). The stratified analysis showed that overall survival was inferior for LAG surgeons with fewer than 40 completed cases. The survival results for surgeons who had performed more than 40 cases were similar to the results from open surgery. CONCLUSIONS: Although LAG yields comparable oncologic outcomes for local AGC, @entity1 with pT4aN3bM0 @entity356 may not be suitable for laparoscopic surgery, especially for surgeons with limited experience.
