Long-Term Outcomes of Laparoscopic Distal Gastrectomy for Locally Advanced Gastric Cancer: The KLASS-02-RCT Randomized Clinical Trial

• DOI: 10.1200/jco.20.01210
• Publication Date: 2020-08-20T19:59:11Z
• Authors: Woo Jin Hyung; Han-Kwang Yang; Young-Kyu Park; Hyuk-Joon Lee; Ji Yeong An; Wook Kim; Hyoung-Il Kim; Hyung-Ho Kim; Seung Wan Ryu; Hoon Hur; Min-Chan Kim; Seong-Ho Kong; Gyu Seok Cho; Jin-Jo Kim; Do Joong Park; Keun Won Ryu; Young Woo Kim; Jong Won Kim; Joo-Ho Lee; Sang-Uk Han
• Keywords: Clinical endpoint; Lymphadenectomy

PURPOSE It is unclear whether laparoscopic distal gastrectomy for locally advanced gastric cancer oncologically equivalent to open gastrectomy. The noninferiority of subtotal with D2 lymphadenectomy compared surgery in terms 3-year relapse-free survival rate was evaluated. PATIENTS AND METHODS A phase III, open-label, randomized controlled trial conducted patients histologically proven adenocarcinoma suitable primary end point the rate; upper limit hazard ratio (HR) 1.43 between and groups. RESULTS From November 2011 April 2015, 1,050 were randomly assigned laparoscopy (n = 524) or 526). After exclusions, 492 underwent 482 included analysis. group, suffered fewer early complications (15.7% v 23.4%, respectively; P .0027) late (4.7% 9.5%, .0038), particularly intestinal obstruction (2.0% 4.4%, .0447). 80.3% (95% CI, 76.0% 85.0%) group 81.3% 77.0% 85.0%; log-rank .726) group. Cox regression analysis after stratification by surgeon revealed an HR 1.035 0.762 1.406; .827; .039). When stratified pathologic stage, 1.020 0.751 1.385; .900; .030). CONCLUSION Laparoscopic comparable cancer. could be a potential standard treatment option