Published online Aug 27, 2024. doi: 10.4240/wjgs.v16.i8.2451
Revised: June 7, 2024
Accepted: June 25, 2024
Published online: August 27, 2024
Processing time: 202 Days and 8.9 Hours
With the development of minimally invasive surgical techniques, the use of laparoscopic D2 radical surgery for the treatment of locally advanced gastric cancer (GC) has gradually increased. However, the effect of this procedure on survival and prognosis remains controversial. This study evaluated the survival and prognosis of patients receiving laparoscopic D2 radical resection for the treatment of locally advanced GC to provide more reliable clinical evidence, guide clinical decision-making, optimize treatment strategies, and improve the survival rate and quality of life of patients.
To investigate the survival prognosis and influencing factors of laparoscopic D2 radical resection for locally advanced GC patients.
A retrospective cohort study was performed. Clinicopathological data from 652 patients with locally advanced GC in our hospitals from December 2013 to December 2023 were collected. There were 442 males and 210 females. The mean age was 57 ± 12 years. All patients underwent a laparoscopic D2 radical operation for distal GC. The patients were followed up in the outpatient department and by telephone to determine their tumor recurrence, metastasis, and survival. The follow-up period ended in December 2023. Normally distributed data are expressed as the mean ± SD, and normally distributed data are expressed as M (Q1, Q3) or M (range). Statistical data are expressed as absolute numbers or percentages; the χ2 test was used for comparisons between groups, and the Mann-Whitney U nonparametric test was used for comparisons of rank data. The life table method was used to calculate the survival rate, the Kaplan-Meier method was used to construct survival curves, the log rank test was used for survival analysis, and the Cox risk regression model was used for univariate and multifactor analysis.
The median overall survival (OS) time for the 652 patients was 81 months, with a 10-year OS rate of 46.1%. Patients with TNM stages II and III had 10-year OS rates of 59.6% and 37.5%, respectively, which were significantly different (P < 0.05). Univariate analysis indicated that factors such as age, maximum tumor diameter, tumor diffe
A maximum tumor diameter exceeding 4 cm, low tumor differentiation, and pathological TNM stage III were identified as independent risk factors for the 10-year OS rate in patients with locally advanced GC following laparoscopic D2 radical resection for distal GC. Conversely, postoperative chemotherapy was found to be an independent protective factor for the 10-year OS rate in these patients.
Core Tip: Data from multicenter patients with locally advanced gastric cancer (GC) were collected to compare the differences in survival and prognosis between laparoscopic D2 radical surgery and traditional open surgery. The contents of the study included postoperative survival rate, postoperative complication rate, postoperative recovery and quality of life. By comparing and analyzing the efficacy and safety of the two surgical methods, this study aimed to evaluate the actual effect of laparoscopic D2 radical surgery in the treatment of locally advanced GC, provide evidence for the selection of clinical surgical methods, and promote the application of minimally invasive surgical techniques in the treatment of GC.