Randomized clinical trial of laparoscopic versus open distal gastrectomy with D2 lymphadenectomy for clinical T4a gastric cancer

No prospective trial on laparoscopy has been specifically designed for clinical T4a gastric cancer (GC). The randomized UMC-UPPERGI-01 clinical trial at a tertiary hospital in Ho Chi Minh City (Vietnam) compared short-term outcomes of laparoscopic distal gastrectomy (LDG) versus open distal gastrectomy (ODG) with D2 lymphadenectomy for clinical T4a GC, with 104 patients in each group. No significant differences were found in 30-day morbidity and mortality, including rates of any postoperative complication (22.1% versus 21.2%) and severe complications (2.9% versus 3.8%). The authors conclude that the results of this randomized clinical trial provide robust evidence that LDG, when performed by qualified surgeons, may be a safe and appropiate treatment option for clinical T4a GC.