Abstract
Background
Laparoscopic gastrectomy (LG) is reported to be associated with faster recovery than
open gastrectomy (OG); however, the influence of the surgical approach on initiation
timing of adjuvant chemotherapy (AC) remains unclear.
Methods
This was a single-institutional retrospective observational study. Patients with pathological
stage II/III gastric cancer undergoing LG with D2 lymphadenectomy (LG group: n = 74)
were matched 1:1 with patients selected from 214 similar patients undergoing OG (OG
group: n = 74), identically matching gender, age, pathological stage, and type of
gastrectomy, and comparing AC initiation timing between the two groups. Factors associated
with delayed initiation of AC were investigated in a multivariable analysis.
Results
AC was performed in 86.5% (LG) and 83.8% (OG) of patients (p = 0.64). The median time interval before AC was significantly shorter in the LG vs.
OG group (5.7 vs. 6.6 weeks, respectively, p < 0.001), and significantly more patients received AC within 6 weeks (60.8% vs. 27.0%,
p < 0.001). Independent factors associated with delayed initiation of AC (>6 weeks)
were: morbidity (≥grade 3a; odds ratio (OR): 16.1, 95% confidence interval (CI): 1.86–143),
open surgery (OR: 5.17, 95% CI: 2.50–13.1), and postoperative weight loss ≥ 8% (OR:
2.47, 95% CI: 1.07–5.71).
Conclusions
LG may be associated with shorter intervals before AC. Postoperative morbidity should
be reduced as much as possible.
Keywords
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Article info
Publication history
Published online: January 29, 2017
Accepted:
January 12,
2017
Identification
Copyright
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
