Minimally Invasive Surgery Option Preferable for Stomach Cancer Patients

An innovative, minimally invasive surgical approach to treat stomach cancer has been shown to have advantages that may make it a preferable treatment for some patients, according to a new study.

Researchers at Memorial Sloan-Kettering Cancer Center (MSKCC; New York, NY, USA) conducted a case-controlled study in patients with adenocarcinoma selected from a prospective gastric cancer database. Thirty consecutive patients undergoing laparoscopic subtotal gastrectomy were compared with 30 patients undergoing open subtotal gastrectomy. Controls were matched for stage, age, and gender via a statistically generated selection of all gastrectomies performed during the same period of time. Patient demographics, tumor-node-metastasis (TNM) stage, histologic features, location of tumor, lymph node retrieval, recurrence, margins, and early and late postoperative complications were compared.

The study results showed that tumor location and histology were similar between the two groups. Median operative time for the laparoscopic approach was 270 minutes, compared with a median of 126 minutes in the open group. Hospital stay after laparoscopic gastrectomy was 5 days, compared with 7 days in the open group. Postoperative pain, as measured by number of days of intravenous (IV) narcotic use, was significantly lower for laparoscopic patients, with a median of 3 days, compared with 4 days in the open group. Postoperative early complications trended towards a decrease for laparoscopic versus open surgery patients, but there were also significantly more late complications for the open group. Short-term recurrence-free survival and margin status was similar between the two groups, with adequate lymph node retrieval in both groups.

"Our number one goal in treating patients with stomach cancer is to remove the cancer completely and safely, while preserving his or her quality of life," said lead author Vivian Strong, M.D., of the department of surgery. "Laparoscopic gastrectomy is an excellent option for certain patients with the disease, and for those patients, this approach has the same success rate as standard open surgery, with significantly fewer complications.”

According to the authors, an additional benefit seen among the patients who underwent laparoscopic gastrectomy was that this approach still enabled adequate lymph node retrieval to determine whether the cancer had spread, as well as parallel examination of other oncologic features of the resection.

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Memorial Sloan-Kettering Cancer Center