T4a 위암을 대상으로 한 복강경 위절제술과 개복 위절제술의 수술관련 예후 및 종양학적 예후 비교

Abstract

Purpose: Laparoscopic gastrectomy (LG) has gradually increased for treatment of advanced gastric cancer. However, LG for T4a advanced gastric cancer is controversial. The aim of the present study is to evaluate the surgical and oncologic outcomes between laparoscopic and open gastrectomy (OG) for T4a gastric cancer. Methods: We retrospectively reviewed 711 patients who underwent OG and 94 patients who underwent LG for T4a gastric cancer between August, 2005 and December, 2016. Finally, 86 patients of LG group and 161 patients of OG group were enrolled according to one to two propensity score matching (PSM) analysis. We evaluated surgical and oncological outcomes including overall survival (OS) and recurrence-free survival (RFS). Results: There were no statistically differences in hospital stay and complication between the two groups. LG group had longer operation time compared to OG group (p=0.04). The retrieved lymph nodes of LG group was higher than that of OG (40.45 ± 16.65 vs 33.14 ± 11.39, p<0.0001). Also, there was no statistically difference in OS between the two groups. However, RFS of LG group was significantly longer than that of OG group (p=0.025). Conclusion: Laparoscopic gastrectomy could be considered for treatment of T4a gastric cancer.