The usefulness of indocyanine green (ICG)–guided lymphadenectomy in robotic gastrectomy for advanced gastric cancer: A single-center retrospective study.

Authors

Chul Hyo Jeon

Chul Hyo Jeon

Department of Surgery, Seoul, South Korea;

Chul Hyo Jeon , Ho Seok Seo

Organizations

Department of Surgery, Seoul, South Korea; , Seoul St.Mary's Hospital, Seoul, South Korea;

Research Funding

No funding received
None.

Background: In performing radical gastrectomy for advanced gastric cancer, the method to evaluate the achievement of lymphadenectomy is under debate. According to the current guideline, obtaining at least 16 lymph nodes is recommended, but in previous studies on advanced gastric cancer, some suggested mid-20 or 30 as a cut-off. This study aimed to find significant factors affecting successful lymphadenectomy for gastric cancer by applying a more stringent condition than the current guideline. Methods: A total of 1 948 patients who underwent laparoscopic and robotic gastrectomy for gastric cancer between January 2016 and February 2022 at Seoul St. Mary’s Hospital were recruited in this study. After exclusion, 393 patients with a pathologically advanced stage were included in the analysis, and their clinicopathological data, including the information about the indocyanine green (ICG)-guided lymphadenectomy, were retrospectively reviewed. Results: Among 393 patients, there were 288 patients in the conventional laparoscopy group (G1), 61 patients in the ICG-guided laparoscopy group (G2), and 44 patients in the ICG-guided robotic surgery group (G3). Patients in the G3 group had a significantly higher proportion of younger patients and a lower proportion with comorbidity. There was a similar trend in stage II and III ratio between the groups and the number of examined lymph nodes (ELNs) did not show a significant difference between groups (45.2±20.3 vs. 51.6±24.5 vs. 50.8±19.6, P=0.058). The ratio of 30 or fewer ELNs was the lowest in G3 (24% vs. 19.7% vs. 9.1%, P=0.050). The rate of exceeding 30 ELNs was increased in the case of higher node stage and more advanced cancer. In the multivariable analysis, the ICG-guided robotic surgery group was confirmed to be a significant factor for more than 30 ELNs (OR=3.151, 1.074~9.245, P=0.037). Conclusions: ICG-guided robotic gastrectomy could be useful in obtaining >30 ELNs compared to conventional laparoscopic gastrectomy in selected cases.

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Abstract Details

Meeting

2023 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach and Other GI Cancers

Track

Esophageal and Gastric Cancer,Other GI Cancer

Sub Track

Therapeutics

Citation

J Clin Oncol 41, 2023 (suppl 4; abstr 390)

DOI

10.1200/JCO.2023.41.4_suppl.390

Abstract #

390

Poster Bd #

G12

Abstract Disclosures

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