Comparison of surgical outcomes in laparoscopic gastrectomy for advanced gastric cancer between Japanese and Italian cohorts: an international, propensity score-matched investigation (the Shinkansen Study).

IF 6.1 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastric Cancer Pub Date : 2026-08-11 DOI:10.1007/s10120-026-01788-x

Pietro Maria Lombardi, Mitsumasa Yoshida, Gian Luca Baiocchi, Etsuro Bando, Alberto Biondi, Paolo De Martini, Stefano De Pascale, Federica Filippini, Gianluca Garulli, Simone Giacopuzzi, Federico Marchesi, Marco Milone, Sarah Molfino, Souya Nunobe, Massimo Oldani, Stefano Olmi, Stefano Rausei, Rossella Reddavid, Riccardo Rosati, Hisashi Shinohara, Kazumitsu Suzuki, Leonardo Solaini, Fabio Staderini, Jacopo Viganò, Davide Bernasconi, Giovanni Ferrari, Takahiro Kinoshita

{"title":"Comparison of surgical outcomes in laparoscopic gastrectomy for advanced gastric cancer between Japanese and Italian cohorts: an international, propensity score-matched investigation (the Shinkansen Study).","authors":"Pietro Maria Lombardi, Mitsumasa Yoshida, Gian Luca Baiocchi, Etsuro Bando, Alberto Biondi, Paolo De Martini, Stefano De Pascale, Federica Filippini, Gianluca Garulli, Simone Giacopuzzi, Federico Marchesi, Marco Milone, Sarah Molfino, Souya Nunobe, Massimo Oldani, Stefano Olmi, Stefano Rausei, Rossella Reddavid, Riccardo Rosati, Hisashi Shinohara, Kazumitsu Suzuki, Leonardo Solaini, Fabio Staderini, Jacopo Viganò, Davide Bernasconi, Giovanni Ferrari, Takahiro Kinoshita","doi":"10.1007/s10120-026-01788-x","DOIUrl":null,"url":null,"abstract":"Background: Marked differences in advanced gastric cancer (AGC) surgical outcomes have historically been documented between Eastern and Western centers. This study compared laparoscopic gastrectomy (LG) surgical outcomes for AGC between Japanese and Italian institutions.Methods: This international, retrospective cohort study included patients undergoing LG for AGC at 17 Italian (within the Italian Research Group for Gastric Cancer) and 5 Japanese institutions (2015-2022). Propensity score matching (PSM) was used to balance baseline characteristics. The primary endpoint was 90-day severe morbidity (Clavien-Dindo ≥ III). Secondary endpoints were 90-day mortality, R0 resection rates, and lymph node (LN) yield. Multivariable regression identified predictors of severe morbidity.Results: From 1,617 patients, PSM selected 566 cases (283 per group). The Italian group (IG) showed a trend toward higher 90-day severe morbidity (14.8% vs. 9.2%, p = 0.052) and 90-day mortality (1.8% vs. 0.4%, p = 0.218) compared to the Japanese group (JG), though differences were not statistically significant. R0 resection rates were similar (96.1% vs. 98.6%, p = 0.115). Median harvested LNs were lower in the IG (34 vs. 43, p < 0.001). Multivariable analysis identified male sex and total gastrectomy, but not country of surgery, as independent predictors of 90-day severe morbidity.Conclusions: In propensity-matched cohorts, LG for AGC showed a clinical trend favoring the JG regarding severe morbidity, without reaching statistical significance. Country of surgery was not an independent predictor of severe complications. While some results are converging, suggesting an acceptable quality of care in Western institutions, the historical surgical gap between these specific Eastern and Western settings has not been completely bridged and better surgical outcomes in Japan persist.","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1000,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastric Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10120-026-01788-x","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Marked differences in advanced gastric cancer (AGC) surgical outcomes have historically been documented between Eastern and Western centers. This study compared laparoscopic gastrectomy (LG) surgical outcomes for AGC between Japanese and Italian institutions.

Methods: This international, retrospective cohort study included patients undergoing LG for AGC at 17 Italian (within the Italian Research Group for Gastric Cancer) and 5 Japanese institutions (2015-2022). Propensity score matching (PSM) was used to balance baseline characteristics. The primary endpoint was 90-day severe morbidity (Clavien-Dindo ≥ III). Secondary endpoints were 90-day mortality, R0 resection rates, and lymph node (LN) yield. Multivariable regression identified predictors of severe morbidity.

Results: From 1,617 patients, PSM selected 566 cases (283 per group). The Italian group (IG) showed a trend toward higher 90-day severe morbidity (14.8% vs. 9.2%, p = 0.052) and 90-day mortality (1.8% vs. 0.4%, p = 0.218) compared to the Japanese group (JG), though differences were not statistically significant. R0 resection rates were similar (96.1% vs. 98.6%, p = 0.115). Median harvested LNs were lower in the IG (34 vs. 43, p < 0.001). Multivariable analysis identified male sex and total gastrectomy, but not country of surgery, as independent predictors of 90-day severe morbidity.

Conclusions: In propensity-matched cohorts, LG for AGC showed a clinical trend favoring the JG regarding severe morbidity, without reaching statistical significance. Country of surgery was not an independent predictor of severe complications. While some results are converging, suggesting an acceptable quality of care in Western institutions, the historical surgical gap between these specific Eastern and Western settings has not been completely bridged and better surgical outcomes in Japan persist.

查看原文本刊更多论文

腹腔镜胃切除术治疗晚期胃癌的手术效果比较：一项国际倾向评分匹配调查（新干线研究）。

背景：东西方研究中心在晚期胃癌（AGC）手术结果上有明显差异。本研究比较了日本和意大利机构腹腔镜胃切除术（LG）治疗AGC的手术结果。方法：这项国际回顾性队列研究纳入了17个意大利（在意大利胃癌研究小组内）和5个日本机构（2015-2022）接受LG治疗AGC的患者。倾向评分匹配（PSM）用于平衡基线特征。主要终点为90天严重发病率（Clavien-Dindo≥III）。次要终点为90天死亡率、R0切除率和淋巴结（LN）生成率。多变量回归确定了严重发病率的预测因子。结果：从1617例患者中，PSM选择了566例（每组283例）。与日本组（JG）相比，意大利组（IG）的90天重症发病率（14.8%比9.2%,p = 0.052）和90天死亡率（1.8%比0.4%,p = 0.218）有更高的趋势，但差异无统计学意义。R0切除率相似（96.1%比98.6%,p = 0.115）。结论：在倾向匹配的队列中，AGC的LG在严重发病率方面显示出有利于JG的临床趋势，但没有达到统计学意义。手术国家并不是严重并发症的独立预测因素。虽然一些结果正在趋同，表明西方机构的护理质量是可以接受的，但这些特定的东西方环境之间的历史手术差距并没有完全弥合，日本的手术效果仍然更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Gastric Cancer 医学-胃肠肝病学

CiteScore

14.70

自引率

2.70%

发文量

审稿时长

6-12 weeks

期刊介绍： Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.