Published online Nov 16, 2023. doi: 10.12998/wjcc.v11.i32.7795
Peer-review started: September 21, 2023
First decision: October 9, 2023
Revised: October 10, 2023
Accepted: October 30, 2023
Article in press: October 30, 2023
Published online: November 16, 2023
Processing time: 55 Days and 18.4 Hours
Gastric cancer is a significant global health concern, and treatment of locally advanced gastric cancer (LAGC) remains challenging. Laparoscopic gastrectomy (LG) has gained acceptance as a minimally invasive approach for early gastric cancer treatment; however, its role in LAGC after neoadjuvant therapy (NAT) is still debated. Open gastrectomy (OG) is the traditional surgical approach for LAGC; however, it is associated with significant morbidity and a longer recovery time. Therefore, there is a need to assess the efficacy and safety of LG compared to those of OG in the context of LAGC after NAT.
The motivation behind this study is to address the controversy surrounding the role of LG in the treatment of LAGC after NAT. Although LG is widely accepted as a minimally invasive approach for early gastric cancer, its effectiveness and safety in LAGC after NAT remain debated. By comparing LG with OG in terms of overall survival (OS), disease-free survival (DFS), surgical complications, and quality of life (QOL), this study aimed to provide evidence of the suitability of LG as an alternative to OG for patients with LAGC. Additionally, this study aimed to identify the potential benefits of LG, such as reduced blood loss, shorter hospital stays, lower incidence of surgical site infection, and improved QOL scores in multiple domains.
The main objectives of this study were to compare the efficacy and safety of LG with OG after NAT for LAGC and to evaluate the impact of these surgical approaches on patient outcomes and QOL.
This prospective study compared the efficacy and safety of LG vs OG after NAT for LAGC. A total of 76 patients with LAGC who underwent NAT were included in the study, with 38 patients undergoing LG and 38 patients undergoing OG between 2021 and 2023. The novelty of this study lies in the comparison of LG and OG after NAT in patients with LAGC, focusing on survival outcomes, surgical complications, and QOL. By conducting a prospective study and utilizing statistical analysis, this study provides valuable insights into the efficacy and safety of LG as an alternative to OG in the treatment of LAGC. These findings contribute to the existing knowledge and help in making evidence-based recommendations for selecting the optimal surgical approach for patients with LAGC after NAT.
The research results demonstrated that LG is a viable and safe alternative to OG for the treatment of LAGC after NAT. The study compared the efficacy and safety of LG vs OG in 76 LAGC patients who underwent NAT. The OS and DFS rates were similar between the LG and OG groups. LG had several advantages, including reduced blood loss, a shorter hospital stay, and a lower incidence of surgical site infection compared to OG. Both groups had comparable rates of other surgical complications. Additionally, LG resulted in better QOL scores in multiple domains at 6 mo postoperatively. These findings contribute to the field by providing evidence-based recommendations for selecting the optimal surgical approach for LAGC patients after NAT. However, further research is needed to explore long-term survival outcomes and refine patient selection criteria.
We compared the efficacy and safety of LG vs OG after NAT for treating LAGC. This study aimed to provide evidence-based recommendations for selecting the optimal surgical approach for patients with LAGC after NAT, based on a comparison of outcomes and QOL between LG and OG.
Future research should prioritize investigating long-term survival outcomes, refining patient selection criteria, conducting comparative cost analyses, and standardizing NAT protocols. These efforts aim to enhance the management of LAGC after NAT. By gaining a deeper understanding of the effectiveness and durability of treatment options such as LG vs OG, identifying specific patient characteristics for optimized surgical approaches, assessing economic implications, and establishing standardized protocols, future studies can contribute to improved patient outcomes and inform clinical decision-making in the treatment of LAGC.