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Improved survival a...
Improved survival after laparoscopic compared to open gastrectomy for advanced gastric cancer: a Swedish population-based cohort study
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- Tsekrekos, A. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska Univ Hosp, Dept Upper Abdominal Surg, C1 77, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Halsovagen 13, S-14157 Stockholm, Sweden.,Karolinska University Hospital
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- Vossen, L. E. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska Univ Hosp, Dept Upper Abdominal Surg, C1 77, Stockholm, Sweden.;Karolinska Inst, Ctr Bioinformat & Biostat, Stockholm, Sweden.,Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Halsovagen 13, S-14157 Stockholm, Sweden.;Odense Univ Hosp, Dept Surg, Odense, Denmark.,Karolinska University Hospital,Odense University Hospital
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Lundell, L. (författare)
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- Jeremiasen, Martin (författare)
- Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Upper Gastrointestinal Surgery,Forskargrupper vid Lunds universitet,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Surg, Lund, Sweden.
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- Johnsson, Erik, 1966 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Surg,Sahlgrenska Univ Hosp, Gothenburg, Sweden.,Sahlgrenska University Hospital
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- Hedberg, Jakob, 1972- (författare)
- Uppsala universitet,Uppsala University,Gastrointestinalkirurgi
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- Edholm, David (författare)
- Linköping University,Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US,Linköping Univ, Dept Surg Biomed & Clin Sci, Linköping, Sweden.
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- Klevebro, F. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska Univ Hosp, Dept Upper Abdominal Surg, C1 77, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Halsovagen 13, S-14157 Stockholm, Sweden.,Karolinska University Hospital
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- Nilsson, M. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska Univ Hosp, Dept Upper Abdominal Surg, C1 77, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Halsovagen 13, S-14157 Stockholm, Sweden.,Karolinska University Hospital
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- Rouvelas, I. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska Univ Hosp, Dept Upper Abdominal Surg, C1 77, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Halsovagen 13, S-14157 Stockholm, Sweden.,Karolinska University Hospital
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Karolinska Institutet Karolinska Univ Hosp, Dept Upper Abdominal Surg, C1 77, Stockholm, Sweden;Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Surg, Halsovagen 13, S-14157 Stockholm, Sweden. (creator_code:org_t)
- 2023-02-19
- 2023
- Engelska.
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Ingår i: Gastric Cancer. - : Springer Science and Business Media LLC. - 1436-3291 .- 1436-3305. ; 26, s. 467-477
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Abstract
Ämnesord
Stäng
- BackgroundLaparoscopic gastrectomy is increasingly used for the treatment of locally advanced gastric cancer but concerns remain whether similar results can be obtained compared to open gastrectomy, especially in Western populations. This study compared the short-term postoperative, oncological and survival outcomes following laparoscopic versus open gastrectomy based on data from the Swedish National Register for Esophageal and Gastric Cancer.MethodsPatients who underwent surgery with curative intent for adenocarcinoma of the stomach or gastroesophageal junction Siewert type III from 2015 to 2020 were identified, and 622 patients with cT2-4aN0-3M0 tumors were included. The impact of surgical approach on short-term outcomes was assessed using multivariable logistic regression. Long-term survival was compared using multivariable Cox regression.ResultsIn total, 350 patients underwent open and 272 laparoscopic gastrectomy, of which 12.9% were converted to open surgery. The groups were similar regarding distribution of clinical disease stage (27.6% stage I, 46.0% stage II, and 26.4% stage III). Neoadjuvant chemotherapy was administered to 52.7% of the patients. There was no difference in the rate of postoperative complications, but laparoscopic approach was associated with lower 90 day mortality (1.8 vs 4.9%, p = 0.043). The median number of resected lymph nodes was higher after laparoscopic surgery (32 vs 26, p < 0.001), while no difference was found in the rate of tumor-free resection margins. Better overall survival was observed after laparoscopic gastrectomy (HR 0.63, p < 0.001).ConclusionsLaparoscopic gastrectomy can be safely preformed for advanced gastric cancer and is associated with improved overall survival compared to open surgery.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Advanced gastric cancer
- Laparoscopic gastrectomy
- Minimally invasive
- surgery
- Survival
- phase-iii trial
- distal gastrectomy
- perioperative chemotherapy
- adjuvant chemotherapy
- follow-up
- surgery
- adenocarcinoma
- dissection
- outcomes
- disease
- Oncology
- Gastroenterology & Hepatology
- Advanced gastric cancer; Laparoscopic gastrectomy; Minimally invasive surgery; Survival
- Minimally invasive surgery
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
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Tsekrekos, A.
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Vossen, L. E.
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Lundell, L.
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Jeremiasen, Mart ...
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Johnsson, Erik, ...
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Hedberg, Jakob, ...
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visa fler...
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Edholm, David
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Klevebro, F.
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Nilsson, M.
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Rouvelas, I.
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Cancer och onkol ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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Gastric Cancer
- Av lärosätet
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Göteborgs universitet
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Karolinska Institutet
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Linköpings universitet
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Lunds universitet
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Uppsala universitet