Defining the Role of Laparoscopic Gastrectomy for Gastric Cancer
Menée sur 2 976 patients atteints d'un cancer de l'estomac traité entre 1998 et 2005 (durée médiane de suivi : 70,8 mois), cette étude évalue l'efficacité sur le long terme, du point de vue des taux de survie, et la sécurité d'une gastrectomie par voie laparoscopique par rapport à une gastrectomie par voie ouverte
Kimetal present one of the largest case-matched series comparing the long-term results of laparoscopic gastrectomy with the open approach for patients with surgically resectable gastric cancer. The authors are to be commended for this comprehensive, high-quality analysisthathighlightsallofthekeyelementsofavaluablestudy. All 10 participating surgeons were from multiple high-volume centers performing at least 80 gastrectomies per year, removing institutional and referral-based bias and ensuring surgeon expertise. The cohort included nearly 3 000 patients with uniform approaches to staging and treatment that included approximately 1 500 laparoscopic and 1 500 open gastrectomies over a 7-year period. Five-year actual survival was analyzed, as was morbidity, mortality, and learning curve. Given that the population included all Korean patients, this was a homogeneous cohort of patients with relative standardization of work-up, treatment options, and ethnicity. All data were collected prospectively by an experienced data collection assistant and analyzed by a medical
statistician who matched all cases for extent of resection, lymphadenectomy, body mass index, surgeons, and stage of tumor. This case-controlled and case-matched analysis of a multiinstitutional experience results in an analysis that provides reliable conclusions, to the extent possible by a retrospective study...
Journal of Clinical Oncology , éditorial en libre accès, 2014