key papersKey paper
JCOG0912: laparoscopy-assisted versus open distal gastrectomy for clinical stage IA or IB gastric cancer
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.
Overview
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.
Randomised controlled trialChanged practice921 participants
Authors
Katai H, Mizusawa J, Katayama H, et al.
Published
The Lancet Gastroenterology and Hepatology, 2020
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.