Comparison of minimally invasive surgery and open surgery following chemotherapy for cStage IVb gastric cancer: a multicenter retrospective cohort study - Summary - MDSpire

Evaluation of Minimally Invasive versus Open Surgical Approaches after Chemotherapy in Patients with Stage IVb Gastric Cancer: A Multicenter Retrospective Analysis

  • By

  • Yusuke Fujii

  • Shigeo Hisamori

  • Nobuaki Hoshino

  • Seiichiro Kanaya

  • Eiji Tanaka

  • Yoshito Yamashita

  • Akira Miki

  • Kosuke Toda

  • Michihiro Yamamoto

  • Yosuke Kinjo

  • Dai Manaka

  • Hiroaki Hata

  • Hironori Kawada

  • Shotaro Matsuda

  • Atsushi Itami

  • Kyoichi Hashimoto

  • Kenjiro Hirai

  • Sanae Nakajima

  • Hiroshi Okabe

  • Masazumi Sakaguchi

  • Yuichiro Kawamura

  • Takashi Sakamoto

  • Shintaro Okumura

  • Tatsuto Nishigori

  • Shigeru Tsunoda

  • Kazutaka Obama

  • July 20, 2026

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Objective:

To compare perioperative and survival outcomes between minimally invasive surgery (MIS) and open surgery in patients with stage IV gastric cancer who underwent curative-intent gastrectomy after systemic chemotherapy.

Approach:
  • Study Design: Multicenter retrospective cohort study conducted across 19 institutions, approved by the Ethics Committee of Kyoto University.
  • Patient Cohort: Included adults aged ≥ 18 years with cStage IVb gastric or gastroesophageal junction adenocarcinoma who underwent curative-intent surgery after chemotherapy from January 2011 to December 2022.
  • Surgical Indications: Determined by multidisciplinary consensus based on the achievability of R0 resection post-chemotherapy.
  • Outcomes: Primary outcome was postoperative complications (Clavien–Dindo grade ≥ II); secondary outcomes included 30-day mortality, operative time, blood loss, lymph node dissection, and survival metrics.
Key Findings:
  • The primary outcome was postoperative complications (Clavien–Dindo grade ≥ II); secondary outcomes included 30-day mortality, operative time, blood loss, lymph node dissection, and survival metrics.
Interpretation:

The comparative safety and oncologic adequacy of MIS versus open gastrectomy in stage IV gastric cancer remain unclear due to fragmented evidence.

Limitations:
  • Small, single-institutional cohorts in existing literature.
  • Variability in surgeon experience and surgical era not accounted for.
Conclusion:

The study aims to provide robust evidence on the outcomes of MIS versus open surgery in a multicenter setting.

Sources:

Original Source(s)

Comparison of minimally invasive surgery and open surgery following chemotherapy for cStage IVb gastric cancer: a multicenter retrospective cohort study

  • by Yusuke Fujii, Shigeo Hisamori, Nobuaki Hoshino, Seiichiro Kanaya, Eiji Tanaka, Yoshito Yamashita, Akira Miki, Kosuke Toda, Michihiro Yamamoto, Yosuke Kinjo, Dai Manaka, Hiroaki Hata, Hironori Kawada, Shotaro Matsuda, Atsushi Itami, Kyoichi Hashimoto, Kenjiro Hirai, Sanae Nakajima, Hiroshi Okabe, Masazumi Sakaguchi, Yuichiro Kawamura, Takashi Sakamoto, Shintaro Okumura, Tatsuto Nishigori, Shigeru Tsunoda, Kazutaka Obama

  • July 20, 2026

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