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Background: Laparoscopy-assisted gastrectomy is a feasible and safe procedure for treating advanced gastric cancer in terms of short-term outcomes. However, concern about long-term oncologic outcomes has limited the adoption of laparoscopy-assisted gastrectomy for advanced gastric cancer., Methods: We launched a prospective randomized controlled trial comparing laparoscopic and open gastrectomy with D2 lymph node dissection for locally advanced gastric cancer to evaluate long-term oncologic feasibility. The 5-year overall survival, disease-free survival, and tumor recurrences have been determined on an intention-to-treat basis., Results: Between January 2010 and June 2012, a total of 328 patients with preoperative clinical stage T 2-4a N 0-3 M 0 gastric cancer were enrolled in the trial. We excluded 6 patients with unresected tumor, and the remaining 322 patients were randomized to the laparoscopic group (162 patients) or the open group (160 patients) for radical surgery. One patient in laparoscopy-assisted gastrectomy and 4 patients in open gastrectomy were lost to follow-up immediately after discharge, leaving 317 patients (161 in laparoscopy-assisted gastrectomy and 156 in open gastrectomy) eligible for long-term analysis. The 5-year overall survival rate was 49.0% in the laparoscopic group and 50.7% in the open group, and the 5-year disease-free survival rate was 47.2% and 49.6% in the 2 groups, respectively. Kaplan-Meier curves for overall survival and disease-free survival showed no differences between the 2 groups. There was no difference in the 5-year tumor recurrence rate between the 2 procedures., Conclusion: Laparoscopy-assisted gastrectomy can provide comparable long-term survival without an increase in recurrence and metastasis in treating advanced gastric cancer., (Copyright © 2019. Published by Elsevier Inc.)

Background: Laparoscopy-assisted gastrectomy (LAG) has gained acceptance as one of the best treatments for early gastric cancer. However, the application of LAG with D2 lymph node dissection in patients with locally advanced gastric cancer (AGC) remains controversial.Methods: We launched a prospective randomized controlled trial comparing laparoscopic and open gastrectomy with D2 lymph node dissection for locally AGC to evaluate technical safety and oncologic feasibility. The postoperative morbidity and mortality rates were based on the modified intention-to-treat analysis.Results: Between January 2010 and June 2012, a total of 328 patients with preoperative clinical stage T2-3N0-3M0 gastric cancer were enrolled in the trial. Six patients with unresected AGC were excluded, and the remaining 322 patients were randomized to the laparoscopic group (162 patients) or the open group (160 patients) for radical surgery. All patients underwent D2 lymph node dissection including 18 (5.59%) proximal gastrectomies, 196 (60.87%) distal gastrectomies, and 108 (33.54%) total gastrectomies. Six patients (3.70%) in the LAG group were converted to open procedures. The overall complication rate was 11.72% in the LAG group and 14.38% in the open group (P = 0.512). No mortality occurred in either group.Conclusions: The short-term results of the current study suggest that LAG with D2 lymph node dissection is a safe and feasible procedure in treating patients with locally AGC in experienced centers. [ABSTRACT FROM AUTHOR]

Background: CX3CL1 is a member of the chemokine family, and its receptor, CX3CR1, is expressed in pancreatic ductal adenocarcinoma. However, it is unclear whether there is a correlation between the expression of CX3CL1/CX3CR1 axis and the prognosis of patients with pancreatic ductal adenocarcinoma. Methods: Tissue microarray and immunohistochemistry were used to study the expression of CX3CL1 and CX3CR1 in 105 specimens of pancreatic ductal adenocarcinoma. We analyzed a relationship between patients' clinicopathological parameters and overall survival to the expression level of the CX3CL1/CX3CR1 axis using standard statistical analysis. Results: The expression of CX3CL1 and CX3CR1 (77.1 and 66.7 %, respectively) was clearly increased in areas of malignancy compared with peritumoral areas. We did not find any correlation between CX3CL1 and CX3CR1 expression with clinical or pathological data. Patients' overall survival was clearly worse with the combined high expression of CX3CL1 and CX3CR1. Patients with a high CX3CL1 expression tumor had a significantly shorter overall survival. High CX3CR1 expression was an independent negative prognosis factor. Conclusion: We propose that the expression level of CX3CL1/CX3CR1 axis could provide clinical prognostic value, and the next steps should be to further investigate the mechanism by which CX3CL1 and its receptor impact survival in pancreatic ductal adenocarcinoma. [ABSTRACT FROM AUTHOR]