对比浆膜侵犯的进展期胃癌患者行腹腔镜与开腹胃癌根治术的手术及肿瘤学结局：一项倾向评分匹配的回顾性研究。
Comparing surgical and oncologic outcomes between laparoscopic gastrectomy and open gastrectomy in advanced gastric cancer with serosal invasion: A retrospective study with propensity score matching.
机构信息
Department of Stomach Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Division of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
出版信息
Eur J Surg Oncol. 2022 Sep;48(9):1988-1993. doi: 10.1016/j.ejso.2022.05.019. Epub 2022 May 23.
PURPOSE
Laparoscopic gastrectomy (LG) has gradually increased for treating advanced gastric cancer (AGC). However, there is a lack of evidence on oncologic safety for AGC, especially with serosal invasion. This study evaluates the surgical and oncologic outcomes between laparoscopic and open gastrectomy (OG) for gastric cancer with serosal invasion.
METHODS
We retrospectively reviewed 256 patients who underwent OG and 147 patients who underwent LG for gastric cancer with serosal invasion between August 2005 and December 2017. Finally, 124 patients in the LG group and 124 in the OG group were enrolled according to one-to-one propensity score matching (PSM) analysis. We evaluated surgical and oncological outcomes, including overall survival (OS) and recurrence-free survival (RFS).
RESULTS
There were no statistical differences in hospital stay and major complications between the two groups. The retrieved lymph nodes of the LG group were similar to those of OG (40 ± 16.23 vs. 38 ± 14.42, p = 0.306), and it showed a similar operation time compared with the other (164 ± 43.86 vs. 156 ± 37.66, p = 0.063). There was no statistical difference in OS (p = 0.761) and RFS (p = 0.121) for survival analysis between the two groups.
CONCLUSION
LG for gastric cancer with serosal invasion is feasible and could be considered as a standard treatment.
目的
腹腔镜胃切除术（LG）已逐渐用于治疗进展期胃癌（AGC）。然而，对于 AGC 患者，特别是伴有浆膜侵犯的患者，其肿瘤安全性方面的证据尚缺乏。本研究旨在评估腹腔镜与开腹胃切除术（OG）治疗伴有浆膜侵犯的胃癌的手术和肿瘤学结局。
方法
我们回顾性分析了 2005 年 8 月至 2017 年 12 月期间接受 OG 和 LG 治疗的 256 例伴有浆膜侵犯的胃癌患者和 147 例伴有浆膜侵犯的胃癌患者。最终，根据 1:1 倾向评分匹配（PSM）分析，LG 组和 OG 组分别纳入 124 例患者。我们评估了两组的手术和肿瘤学结局，包括总生存期（OS）和无复发生存期（RFS）。
结果
两组患者的住院时间和主要并发症无统计学差异。LG 组的淋巴结检出数与 OG 组相似（40 ± 16.23 枚比 38 ± 14.42 枚，p = 0.306），手术时间也与 OG 组相似（164 ± 43.86 分钟比 156 ± 37.66 分钟，p = 0.063）。生存分析显示两组的 OS（p = 0.761）和 RFS（p = 0.121）无统计学差异。
结论
对于伴有浆膜侵犯的胃癌，LG 是一种可行的治疗方法，可作为标准治疗方法。
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