| Purpose: The aim of this study is to compare technical safety and prognosis of laparoscopic gastrectomy (LG) and open gastrectomy (OG) for advanced gastric cancer (AGC) using propensity score (PS) matched analysis. Methods: Between 2007 and 2018, 273 patients (LG: 75, OG: 198) underwent gastrectomy with D2 lymph node dissection for AGC. One-to-one PS matching was done using patients' age, sex, tumor location, cT, cN, tumor size, and type of gastrectomy. Results: After PS matching, 146 patients (LG: 73, OG: 73) were enrolled. pT(T0/1/2/3/4), and pN(N0/1/2/3)in the LG and OG group were 1/18/12/23/19, 1/12/14/26/20 (P=0.612), and 30/14/17/12, 28/15/12/18 (P=0.600), respectively. Number of patients with neo adjuvant chemotherapy were similar between two groups. Longer operation time (LG: 352 OG: 269 min) was required in LG group (P＜0.001), however less intraoperative bleeding (LG: 80 OG: 299 ml) was observed in LG group (P＜0.001). The incidence of Clavien-Dindo grade II or more complications in the LG and OG group were 8.2% and 23.3%, respectively (P=0.013). The length of postoperative hospital stay was 12.2 in LG and 16.5 in OG, which was shorter in the LG group (P=0.006). The 3-year OS (LG: 80%, OG: 79%) and RFS rate (LG: 73%, OG: 70%) were similar between two groups. Conclusion: LG was safe and feasible for the treatment of AGC, with acceptable rate of morbidity and prognosis. |
