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Keyhole removal of the lower stomach for early gastric cancer gave the same five-year survival as open surgery in this large Korean trial, confirming laparoscopic gastrectomy as a standard for stage I disease.
Phase 3 non-inferiority trial of 1,416 patients with clinical stage I gastric cancer randomised to laparoscopic or open distal gastrectomy in 13 Korean centres.
Five-year overall survival was 94.2 percent with laparoscopic and 93.3 percent with open surgery, cancer-specific survival 97.1 versus 97.2 percent, with fewer wound complications after laparoscopic surgery as reported earlier.
Laparoscopic distal gastrectomy is the standard operation for stage I gastric cancer outside endoscopic criteria in East Asia and increasingly elsewhere.