• Hoon Hur, Young Joon Lee, Young-Woo Kim, Jae-Seok Min, Hong Man Yoon, Yeong AnJiJDepartment of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Bang Wool Eom, Seok ChoGyuGDepartment of Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea., Young-Kyu Park, Mi Ran Jung, Ji-Ho Park, Woo Jin Hyung, Sang-Ho Jeong, Myeong-Cherl Kook, Mira Han, Byung-Ho Nam, and Keun Won Ryu.
• Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
• Ann. Surg. 2024 Jan 25.

ObjectiveThis study aimed to compare laparoscopic standard gastrectomy (LSG) and laparoscopic sentinel node navigation surgery (LSNNS) for EGC in terms of 5-year long-term oncologic outcomes.Summary Background DataThe oncological safety of LSNNS for early gastric cancer (EGC) has not been confirmed. Three-year disease-free survival (DFS), which is the primary endpoint of the phase III multicenter randomized controlled clinical trial (SEntinel Node ORIented Tailored Approach [SENORITA] trial), did not show the non-inferiority of LSNNS relative to LSG.MethodsThe SENORITA trial, a multicenter randomized clinical trial, was designed to show that LSNNS is non-inferior to LSG in terms of 3-year DFS. In the present study, we collected 5-year follow-up data from 527 patients recruited in the SENORITA trial as the full analysis set (FAS). Disease-free survival (DFS), overall survival (OS), disease-specific survival (DSS), and recurrence patterns were evaluated using the FAS of both LSG (n=269) and LSNNS (n=258).ResultsThe 5-year DFS was not significantly different between the LSG and LSNNS groups (P=0.0561). During the 5-year follow-up, gastric cancer-related events, such as metachronous cancer, were more frequent in the LSNNS group than in the LSG group. However, ten recurrent cancers in the remnant stomach of both groups were curatively resected by additional gastrectomy and one by additional endoscopic resection. Two of the 198 patients who underwent local resection for stomach preservation based on the LSNNS results developed distant metastasis. However, there was no statistically significant difference in the 5-year OS and DSS (P=0.7403 and P=0.9586, respectively) between the two groups.ConclusionThe 5-year DFS, DSS and OS did not differ significantly between the two groups. Considering the benefits of LSNNS on postoperative quality of life, LSNNS could be recommended as an alternative treatment option for EGC.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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