A feasibility study of laparoscopic total gastrectomy for clinical stage I gastric cancer: a prospective multi-center phase II clinical trial, KLASS 03

Woo Jin Hyung, Han Kwang Yang, Sang Uk Han, Young Jun Lee, Joong Min Park, Jin Jo Kim, Oh Kyung Kwon, Seong Ho Kong, Hyoung Il Kim, Hyuk Joon Lee, Wook Kim, Seung Wan Ryu, Sung Ho Jin, Sung Jin Oh, Keun Won Ryu, Min Chan Kim, Hye Seong Ahn, Young Kyu Park, Young Ho Kim, Sun Hwi HwangJong Won Kim, Gyu Seok Cho

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12 Citations (Scopus)

Abstract

Background: With improved short-term surgical outcomes, laparoscopic distal gastrectomy has rapidly gained popularity. However, the safety and feasibility of laparoscopic total gastrectomy (LTG) has not yet been proven due to the difficulty of the technique. This single-arm prospective multi-center study was conducted to evaluate the use of LTG for clinical stage I gastric cancer. Methods: Between October 2012 and January 2014, 170 patients with pathologically proven, clinical stage I gastric adenocarcinoma located at the proximal stomach were enrolled. Twenty-two experienced surgeons from 19 institutions participated in this clinical trial. The primary end point was the incidence of postoperative morbidity and mortality at postoperative 30 days. The severity of postoperative complications was categorized according to Clavien–Dindo classification, and the incidence of postoperative morbidity and mortality was compared with that in a historical control. Results: Of the enrolled patients, 160 met criteria for inclusion in the full analysis set. Postoperative morbidity and mortality rates reached 20.6% (33/160) and 0.6% (1/160), respectively. Fifteen patients (9.4%) had grade III or higher complications, and three reoperations (1.9%) were performed. The incidence of morbidity after LTG in this trial did not significantly differ from that reported in a previous study for open total gastrectomy (18%). Conclusions: LTG performed by experienced surgeons showed acceptable postoperative morbidity and mortality for patients with clinical stage I gastric cancer.

Original languageEnglish
Pages (from-to)214-222
Number of pages9
JournalGastric Cancer
Volume22
Issue number1
DOIs
Publication statusPublished - 2019 Jan 22

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

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    Hyung, W. J., Yang, H. K., Han, S. U., Lee, Y. J., Park, J. M., Kim, J. J., Kwon, O. K., Kong, S. H., Kim, H. I., Lee, H. J., Kim, W., Ryu, S. W., Jin, S. H., Oh, S. J., Ryu, K. W., Kim, M. C., Ahn, H. S., Park, Y. K., Kim, Y. H., ... Cho, G. S. (2019). A feasibility study of laparoscopic total gastrectomy for clinical stage I gastric cancer: a prospective multi-center phase II clinical trial, KLASS 03. Gastric Cancer, 22(1), 214-222. https://doi.org/10.1007/s10120-018-0864-4