Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 40-48
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.40
Laparoscopic vs open surgery for gastric cancer: Assessing time, recovery, complications, and markers
Yun-Yao Lu, Yun-Xiao Li, Meng He, Ya-Li Wang
Yun-Yao Lu, Yun-Xiao Li, Meng He, Ya-Li Wang, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing 400030, China
Co-first authors: Yun-Yao Lu and Yun-Xiao Li.
Co-corresponding authors: Ya-Li Wang and Meng He.
Author contributions: Lu YY designed and performed the research and wrote the manuscript; Wang YL designed the study and supervised the report; Li YX designed the study and participated in the analysis; He M provided clinical advice and supervised the report; All authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Lu YY and Li YX contributed equally to this work and are the first co-authors. Wang YL and He M contributed equally to this study and are co-corresponding authors. There are two reasons for designating Lu YY and Li YX as co-first authors, and Wang YL and He M as co-corresponding authors. First, the research was performed as a collaborative effort, and the designation of co-first authors and co-corresponding authors accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, they contributed efforts of equal substance throughout the research process. The choice of these researchers as co-first authors and co-corresponding authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Lu YY and Li YX as co-first authors, and Wang YL and He M as co-corresponding authors is fitting for our manuscript as it accurately reflects our team's collaborative spirit and equal contributions.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Chongqing University Cancer Hospital (Approval No. CZLS2023170-A).
Informed consent statement: The authors have applied for exemption from obtaining patients’ informed consent.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The statistical data used in this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Li Wang, MBBS, Technician, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba District, Chongqing 400030, China. wangyali19850810@163.com
Received: September 5, 2023
Peer-review started: September 5, 2023
First decision: September 14, 2023
Revised: September 22, 2023
Accepted: November 8, 2023
Article in press: November 8, 2023
Published online: January 27, 2024
Processing time: 141 Days and 22.6 Hours
Abstract
BACKGROUND

Gastric cancer (GC) is one of the most common cancers worldwide. Morbidity and mortality have increased in recent years, making it an urgent issue to address. Laparoscopic radical surgery (LRS) is a crucial method for treating patients with GC; However, its influence on tumor markers is still under investigation.

AIM

To determine the effects of LRS on patients with GC and their serum tumor markers.

METHODS

The data of 194 patients treated at Chongqing University Cancer Hospital between January 2018 and January 2019 were retrospectively analyzed. Patients who underwent traditional open surgery and LRS were assigned to the control (n = 90) and observation groups (n = 104), respectively. Independent sample t-tests and χ2 tests were used to compare the two groups based on clinical efficacy, changes in tumor marker levels after treatment, clinical data, and the incidence of postoperative complications. To investigate the association between tumor marker levels and clinical efficacy in patients with GC, three-year recurrence rates in the two groups were compared.

RESULTS

Patients in the observation group had a shorter duration of operation, less intraoperative blood loss, an earlier postoperative eating time, and a shorter hospital stay than those in the control group (P < 0.05). No significant difference was observed between the two groups regarding the number of lymph node dissections (P > 0.05). After treatment, the overall response rate in the control group was significantly lower than that in the observation group (P = 0.001). Furthermore, after treatment, the levels of carbohydrate antigen 19-9, cancer antigen 72-4, carcinoembryonic antigen, and cancer antigen 125 decreased significantly. The observation group also exhibited a significantly lower incidence rate of postoperative complications compared to the control group (P < 0.001). Additionally, the two groups did not significantly differ in terms of three-year survival and recurrence rates (P > 0.05).

CONCLUSION

LRS effectively treats early gastric cancer by reducing intraoperative bleeding, length of hospital stays, and postoperative complications. It also significantly lowers tumor marker levels, thus improving the short-term prognosis of the disease.

Keywords: Laparoscopic radical surgery; Gastric cancer; Serum tumor markers; Prognosis; Recurrence; Intraoperative bleeding

Core Tip: Laparoscopic radical surgery (LRS) is an effective treatment option for early gastric cancer (GC). Compared with open surgery, LRS offers shorter operation times, less intraoperative blood loss, quicker postoperative recovery, and fewer complications. LRS also contributes to a better short-term prognosis and significantly reduces the levels of tumor markers, such as carbohydrate antigen 19-9, carbohydrate antigen 72-4, carcinoembryonic antigen, and carbohydrate antigen 125. Even in patients with advanced GC, LRS can lower the incidence of postoperative complications and contribute to favorable long-term prognosis.