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Five-year survival outcomes of laparoscopy-assisted vs open distal gastrectomy for advanced gastric cancer. The JLSSG0901 Randomized Clinical Trial.

Etoh T, Ohyama T, Sakaramoto S, Tsuji T, Lee S-W. Yoshida K et al,  for the Japanese Laparoscopic Surgery Study Group (JLSSG).

JAMA Surg 2023; 158: 445-454.

After five years in this study that included 502 patients, there was no difference between the two procedures in relapse-free survival: 73.9 per cent open versus 75.5 per cent laparoscopic resection, P=0.03 for non inferiority. Nor were there differences in postoperative complications, or overall survival.

Comment: No difference in outcomes, so choice of procedure should be according to patient choice, but perhaps also cost in publicly funded healthcare systems.

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