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Japan's randomised trial confirmed that laparoscopy-assisted distal gastrectomy is not inferior to open surgery for relapse-free survival in stage I gastric cancer, cementing the minimally invasive approach.
Phase 3 non-inferiority trial of 921 patients with clinical stage IA or IB gastric cancer randomised to laparoscopy-assisted or open distal gastrectomy with D1+ or D2 lymphadenectomy at Japanese centres.
Five-year relapse-free survival was 95.1 percent with laparoscopic and 94.0 percent with open surgery, meeting non-inferiority, with similar overall survival and no differences in long-term complications.
Together with KLASS-01, this trial makes laparoscopic distal gastrectomy the standard for early gastric cancer needing surgery.