Understanding the prognostic factors affecting survival of patients with primary gastric cancer treated with laparoscopic surgery

Abstract

The retrospective study by Gan et al evaluated the three-year survival rate and prognostic factors in 100 patients with primary gastric cancer who underwent laparoscopic surgery at a Chinese hospital between 2019 and 2021. The observed three-year survival rate was 73%. Multivariate analysis identified age, tumor-nodes-metastasis stage, tumor size, depth of invasion, lymph node metastasis, extent of lymph node dissection, postoperative adjuvant chemo-radiotherapy, postoperative carcinoembryonic antigen levels, surgical duration, extent of gastric resection, and postoperative complications as independent predictors of survival. Older age, advanced disease stage, larger tumors, deeper invasion, lymph node involvement, and elevated carcinoembryonic antigen were associated with poorer outcomes, while thorough lymph node dissection and adjuvant therapy improved survival. The study highlights the complex interplay of clinical and pathological factors affecting prognosis after laparoscopic surgery. Strengths include detailed perioperative data and robust analysis, though limitations are noted in its retrospective design and patient selection. The findings emphasize the need for multidisciplinary, individualized treatment planning, considering both disease and patient-related factors, to optimize outcomes in localized gastric cancer. Prospective studies are warranted to validate these results and refine treatment strategies.

Keywords: Gastric cancer; Prognostic factors; Multivariate analysis; Laparoscopic surgery; Survival

Core Tip: Laparoscopic surgery offers a promising three-year survival rate for patients with primary gastric cancer; outcomes are significantly influenced by a range of clinical and pathological factors. The findings underscore the importance of multidisciplinary collaboration to decide the optimal treatment plan for each patient. While making treatment decisions, nutritional status and quality of life should also be taken into consideration in addition to disease- and patient-related features. By identifying key risk factors, the study provides valuable insights for optimizing clinical interventions and improving survival among patients treated with laparoscopic surgery for primary gastric cancer.