LATG/LAPG demonstrates excellent long-term efficacy in stage 1 gastric cancer

Patients with stage 1 gastric cancer displayed excellent long-term survival outcomes after laparoscopy-assisted total or proximal gastrectomy (LATG/LAPG). According to the authors, the JCOG1401 study showed that LATG/LAPG can result in comparable results as open procedures.

The JCOG0912 study (UMIN000003319) demonstrated that laparoscopy-assisted distal gastrectomy (LADG) was non-inferior to open distal gastrectomy in patients with clinical stage 1 gastric cancer for safety and relapse-free survival [1,2], indicating that LAPG may be the preferred standard treatment option if experienced surgeons are available. However, until now there have not been any prospective studies investigating LATG and LAPG in patients with early gastric cancer.

Therefore, the single-arm confirmatory JCOG1401 trial (UMIN000017155) included 245 patients with predominantly stage 1 proximal gastric cancer to assess the safety and long-term survival outcomes of LATG/LAPG [3]. The primary endpoint was the rate of grade ≥2 oesophageal anastomotic leak. A previous publication showed that this outcome remained below the expected value of 3.0% [4]. Dr Shinichi Sakuramoto (Saitama Medical University International Medical Center, Japan) presented the survival outcomes after 5 years of follow-up.

The 5-year overall survival rate was 91.2% (95% CI 86.9–94.2) and the 5-year relapse-free survival rate was 90.0% (95% CI 85.5–93.2). According to the authors, the long-term efficacy results for LATG/LAPG are excellent in this population and can match with the survival rates of open procedures.

1. Katai H, et al. Gastric Cancer. 2017;20(4):699–708.
2. Katai H, et al. Lancet Gastroent and Hepatol. 2020;5(2):142–151.
3. Sakuramoto S, et al. Long-term outcomes after laparoscopy-assisted total or proximal gastrectomy with nodal dissection for clinical stage I gastric cancer: Japan Clinical Oncology Group study (JCOG1401). Abstract 305, ASCO GI 2023, 19–21 January, San Francisco, CA, USA.
4. Katai H, et al. Gastric Cancer. 2019;22(5):999–1008.

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Posted on 17 March 202321 May 2024