Abstract 77P
Background
Radical lymph nodes (LNs) dissection is the cornerstone of gastric cancer (GC) surgical treatment. Indocyanine green (ICG) fluorescence imaging-guided lymphadenectomy has been proven to be effective in increasing the number of LNs retrieved in laparoscopic gastrectomy (LG) for GC. However, the long-term oncological efficacy of ICG fluorescence imaging in LG remains uncertain. This randomized clinical trial was conducted to evaluate the long-term oncological efficacy of ICG imaging-guided laparoscopic lymphadenectomy for GC.
Methods
The study was an open-label, randomized clinical trial conducted at a tertiary referral teaching hospital in China. A total of 266 eligible patients with potentially resectable GC (cT1-4a, N0/+, M0) without bulky nodes or distant metastases were enrolled from November 2018 to July 2019. Patients were randomly (1:1 ratio) assigned to the ICG group or the non-ICG group.
Results
Among 266 patients, 258 (97.0%; mean age, 58.9 years; 85 [32.9%] women) completed the study. The mean (SD) total number of LNs retrieved in the ICG group was 50.5 (15.9), which was significantly more than that of the non-ICG group (42.0 [10.3], P < 0.001). The 3-year disease-free survival (DFS) of the ICG group and the non-ICG group were 81.4% and 68.2%, respectively, with an absolute risk difference of 13.2% (Log-rank P = 0.012). The 3-year overall survival (OS) in the ICG group was 86.0%, which was significantly higher than that in the non-ICG group (73.6%; Log-rank P = 0.015). Cox multivariate analysis showed ICG was the independent protective factor for both OS and DFS (OS: HR=0.49, 95%CI: 0.27-0.91; P = 0.023; DFS: HR=0.51, 95%CI: 0.30-0.87; P = 0.014).There were differences in overall recurrence patterns between the ICG and non-ICG groups within 3 years after surgery (17.9% vs. 31.0%, P = 0.014).
Conclusions
For patients with resectable GC, ICG fluorescence imaging-guided laparoscopic lymphadenectomy showed better long-term oncological efficacy than conventional LN dissection, especially in patients undergoing total gastrectomy. These findings provided encouraging evidence for the ongoing, randomized, phase 3, CLASS-11 study (NCT03875235).
Clinical trial identification
NCT03875235.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
57P - V-set and immunoglobulin domain containing 1 (VSIG1): Gene vs protein expression in colorectal cancer tissue samples
Presenter: Simona Gurzu
Session: Poster viewing 02
58P - Clinicopathologic profile and outcomes of rectal cancer (RC) in the young (<50 years old): A single institution experience
Presenter: Fatma Amina Hussin Ibrahim
Session: Poster viewing 02
59P - Platelet-derived growth factor (PDGF)-CC serum as clinical outcome predictor after six cycles of chemotherapy in colorectal cancer at RSMH Palembang
Presenter: Erty Sundarita
Session: Poster viewing 02
60P - Predictors of survival in stage III colorectal cancer patients treated with surgery and adjuvant chemotherapy: A single institution observational study
Presenter: Keng Man Chiang
Session: Poster viewing 02
61P - Can total neoadjuvant therapy in locally advanced rectal cancer replace standard treatment protocol?
Presenter: Ankita Mallick
Session: Poster viewing 02
62P - Chief complaints and baseline clinicopathological features of patients with colorectal cancer in a tertiary hospital in Yogyakarta Indonesia
Presenter: Yasjudan Putra
Session: Poster viewing 02
63P - Tumor sidedness and clinicopathological features of colorectal cancer in Medical Oncology Department, Yangon General Hospital: A retrospective review
Presenter: Thiri Tun
Session: Poster viewing 02
64P - Clinical profile and treatment outcome of patients with non-metastatic colon cancer: A single institutional study from India
Presenter: Sandip Ganguly
Session: Poster viewing 02
65P - Comparison of survival and recurrence pattern in Thai early stage colorectal cancer patients by tumor sidedness
Presenter: Chanchai Charonpongsuntorn
Session: Poster viewing 02