Chen QY, et al. - Researchers compared the long-term outcomes of laparoscopic radical gastrectomy (LG) vs open radical gastrectomy (OG) in gastric adenocarcinoma patients with enlarged lymph nodes (LNs). LG could be chosen preferentially for advanced gastric cancer with an enlarged suprapancreatic LN (ESLN) diameter from 1.0 to 1.9 cm. However, if ESLN were > 2.5 cm, LG was not safe.

Methods

• The researchers retrospectively examined the long-term outcomes of LG (n = 855) vs OG (n = 154) in gastric adenocarcinoma patients.
• They stratified patients according to enlarged (> 10 mm) and small (≤ 10 mm) LNs (ELN and SLN) based on the long-axis diameter of the LNs.

Results

• Between 2 groups, the violin plot indicated that the distribution of ELN size was similar.
• In LG, survival curves demonstrated that the overall survival (OS) was enhanced compared with OG (p=0.034).
• In stratified analysis, the LG group demonstrated better OS compared with the OG group for patients with ELNs (p=0.038).
• For LG, the actual 3-year OS rate was significantly increased compared with OG in enlarged suprapancreatic LN (ESLNs) patients, in a forest map analysis.
• Stratified analysis based on different diameters of ESLNs revealed that the actual 3-year OS and cancer-specific survival (CSS)rate for LG was significantly increased than the OG with a diameter from 1.0 to 1.9 cm for pII or pIII stage patients.
• However, when the size exceeded 2.5 cm, the actual 3-year OS and CSS rate for LG was significantly reduced compared with OG.