# JCOG0912: laparoscopy-assisted versus open distal gastrectomy for clinical stage IA or IB gastric cancer

Source: https://onco.cc/key-papers/paper-jcog0912-katai-lancet-gastroenterol-hepatol-2020/  
OnCo record `paper-jcog0912-katai-lancet-gastroenterol-hepatol-2020` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Japan's randomised trial confirmed that laparoscopy-assisted distal gastrectomy is not inferior to open surgery for relapse-free survival in stage I gastric cancer, cementing the minimally invasive approach.

## Summary

Phase 3 non-inferiority trial of 921 patients with clinical stage IA or IB gastric cancer randomised to laparoscopy-assisted or open distal gastrectomy with D1+ or D2 lymphadenectomy at Japanese centres.

Five-year relapse-free survival was 95.1 percent with laparoscopic and 94.0 percent with open surgery, meeting non-inferiority, with similar overall survival and no differences in long-term complications.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet Gastroenterology and Hepatology
- Year: 2020
- DOI: 10.1016/S2468-1253(19)30332-2
- Authors: Katai H, Mizusawa J, Katayama H, et al.
- Findings: Five-year relapse-free survival 95.1 percent (laparoscopic) vs 94.0 percent (open); non-inferior.
- What it means: Together with KLASS-01, this trial makes laparoscopic distal gastrectomy the standard for early gastric cancer needing surgery.
- Caveats: Applies to distal tumours; total gastrectomy and advanced disease were studied separately.

## Sources

- Lancet Gastroenterol Hepatol 2020: https://doi.org/10.1016/S2468-1253(19)30332-2
- PubMed: https://pubmed.ncbi.nlm.nih.gov/31757656/

## Connected records

- cancers: [Early gastric cancer](https://onco.cc/cancers/early-gastric-cancer/)
- trials: [KLASS-01](https://onco.cc/trials/klass-01/)

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