Long-term oncological outcomes of 3D versus 2D laparoscopic gastrectomy for gastric cancer : a randomized clinical trial
© 2024. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association..
BACKGROUND: Laparoscopy-assisted gastrectomy (LG) is rapidly gaining popularity owing to its minimal invasiveness. Previous studies have found that compared with two-dimensional (2D)-LG, three-dimensional (3D)-LG showed better short-term outcomes. However, the long-term oncological outcomes in patients with locally resectable gastric cancer (GC) remain controversial.
METHODS: In this noninferiority, open-label, randomized clinical trial, a total of 438 eligible GC participants were randomly assigned in a 1:1 ratio to either 3D-LG or 2D-LG from January 2015 to April 2016. The primary endpoint was operating time, while the secondary endpoints included 5-year overall survival (OS), disease-free survival (DFS), and recurrence pattern.
RESULTS: Data from 401 participants were included in the per-protocol analysis, with 204 patients in the 3D group and 197 patients in the 2D group. The 5-year OS and DFS rates were comparable between the 3D and 2D groups (5-year OS: 70.6% vs. 71.1%, Log-rank P = 0.743; 5-year DFS: 68.1% vs. 69.0%, log-rank P = 0.712). No significant differences were observed between the 3D and 2D groups in the 5-year recurrence rate (28.9% vs. 28.9%, P = 0.958) or recurrence time (mean time, 22.6 vs. 20.5 months, P = 0.412). Further stratified analysis based on the type of gastrectomy, postoperative pathological staging, and preoperative BMI showed that the 5-year OS, DFS, and recurrence rates of the 3D group in each subgroup were similar to those of the 2D group (all P > 0.05).
CONCLUSIONS: For patients with locally resectable GC, 3D-LG performed by experienced surgeons in high-volume professional institutions can achieve long-term oncological outcomes comparable to those of 2D-LG.
REGISTRATION NUMBER: NCT02327481 ( http://clinicaltrials.gov ).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association - 27(2024), 3 vom: 20. Apr., Seite 598-610 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhong, Qing [VerfasserIn] |
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| Links: |
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| Themen: |
3D laparoscopic-assisted gastrectomy |
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| Anmerkungen: |
Date Completed 15.04.2024 Date Revised 15.04.2024 published: Print-Electronic ClinicalTrials.gov: NCT02327481 Citation Status MEDLINE |
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| doi: |
10.1007/s10120-024-01470-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368691217 |
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| 500 | |a ClinicalTrials.gov: NCT02327481 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association. | ||
| 520 | |a BACKGROUND: Laparoscopy-assisted gastrectomy (LG) is rapidly gaining popularity owing to its minimal invasiveness. Previous studies have found that compared with two-dimensional (2D)-LG, three-dimensional (3D)-LG showed better short-term outcomes. However, the long-term oncological outcomes in patients with locally resectable gastric cancer (GC) remain controversial | ||
| 520 | |a METHODS: In this noninferiority, open-label, randomized clinical trial, a total of 438 eligible GC participants were randomly assigned in a 1:1 ratio to either 3D-LG or 2D-LG from January 2015 to April 2016. The primary endpoint was operating time, while the secondary endpoints included 5-year overall survival (OS), disease-free survival (DFS), and recurrence pattern | ||
| 520 | |a RESULTS: Data from 401 participants were included in the per-protocol analysis, with 204 patients in the 3D group and 197 patients in the 2D group. The 5-year OS and DFS rates were comparable between the 3D and 2D groups (5-year OS: 70.6% vs. 71.1%, Log-rank P = 0.743; 5-year DFS: 68.1% vs. 69.0%, log-rank P = 0.712). No significant differences were observed between the 3D and 2D groups in the 5-year recurrence rate (28.9% vs. 28.9%, P = 0.958) or recurrence time (mean time, 22.6 vs. 20.5 months, P = 0.412). Further stratified analysis based on the type of gastrectomy, postoperative pathological staging, and preoperative BMI showed that the 5-year OS, DFS, and recurrence rates of the 3D group in each subgroup were similar to those of the 2D group (all P > 0.05) | ||
| 520 | |a CONCLUSIONS: For patients with locally resectable GC, 3D-LG performed by experienced surgeons in high-volume professional institutions can achieve long-term oncological outcomes comparable to those of 2D-LG | ||
| 520 | |a REGISTRATION NUMBER: NCT02327481 ( http://clinicaltrials.gov ) | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a 3D laparoscopic-assisted gastrectomy | |
| 650 | 4 | |a Gastric cancer | |
| 650 | 4 | |a Long-term prognosis | |
| 650 | 4 | |a Post-recurrence survival | |
| 650 | 4 | |a Recurrence patterns | |
| 650 | 4 | |a Recurrence-free survival | |
| 700 | 1 | |a Chen, Jun-Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Shang-Guan, Zhi-Xin |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Zhi-Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Guang-Tan |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Yi-Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Jia-Bin |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Jian-Xian |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Qi-Yue |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Ju-Li |e verfasserin |4 aut | |
| 700 | 1 | |a Xie, Jian-Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Lu, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Chang-Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Chao-Hui |e verfasserin |4 aut | |
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