Comparison of the long-term impact of laparoscopy and open surgery on the prognosis of patients with locally advanced gastric cancer

Currently, the choice of surgical procedure for patients with locally advanced gastric cancer remains controversial. This study aimed to investigate the difference in prognosis between laparoscopy and open surgery in patients with locally advanced gastric cancer and explored the potential patients suitable for laparoscopy. Gastric cancer patients who underwent surgical treatment at Zhejiang Cancer Hospital from 2008 to 2019 were included in this study. We found that surgical method was an independent risk factor for the prognosis of patients with gastric cancer (p < 0.01). The prognosis of laparoscopic surgery is better than that of open surgery two years after surgery (p < 0.05) but shows no difference in overall survival (p > 0.05); in patients with locally advanced cancer, a better prognosis is demonstrated as early as six months after undergoing laparoscopic surgery (p < 0.05). Patients who were male, aged over 60 years, had a history of smoking and drinking, had tumors located in the upper stomach, exhibited poor tumor differentiation, and had normal serum AFP and CA72-4 levels experienced significantly better survival with laparoscopic surgery compared to open surgery (p < 0.05). Finally, a prognostic model in locally advanced cancer patients was developed. Our study suggests that laparoscopy for patients with locally advanced-stage gastric cancer can lead to a better prognosis in these specific situations.