Laparoscopic Resection After Neoadjuvant Chemotherapy for Distal Gastric Tumors: Safe, but Is It Better?
Mené en Chine sur 95 patients atteints d'un cancer de l'estomac de stade localement avancé et ayant reçu une chimiothérapie néoadjuvante (âge médian : 59 ans), cet essai de phase évalue la non infériorité, du point de vue du taux de survie sans récidive à 3 ans, d'une gastrectomie distale laparoscopique par rapport à une gastrectomie distale par voie ouverte, en combinaison avec une lymphadénectomie D2
With great interest, we read Li and colleagues’ article in this issue of JAMA Surgery. The authors sought to compare the short-term outcomes of laparoscopic distal gastrectomy with those of open distal gastrectomy for the treatment of patients with locally advanced (cT2-4aN+M0) distal gastric cancer. In this study, an open-label, single center, phase 2 randomized clinical trial with a noninferiority design, the authors assessed outcomes at 3 years. All patients received neoadjuvant therapy of oxaliplatin and capecitabine before their operation. Li and colleagues reported significantly lower postoperative complication rates, less postoperative pain, and better adherence to and completion of adjuvant therapy among trial participants.
JAMA Surgery , éditorial en libre accès, 2018