Compared with TG, DG is an optimal surgical procedure for middle or lower-third gastric cancer in early and locally advanced stages with better short-term outcomes and comparable long-term prognosis under the precondition of negative proximal resection margin.

Background It remains unclear whether laparoscopic conversation to open gastrectomy causes higher morbidity and has an adverse effect on the long-term survival outcomes of patients with gastric cancer. This study was designed to evaluate the impact of the conversion on short and long-term outcomes of patients with locally advanced gastric cancer (AGC). Methods We retrospectively investigated 871 patients who initially underwent laparoscopic gastrectomy (LG) for pathologically confirmed diagnosis of AGC between February 2009 and April 2018. The patients were grouped as the conversion (CONV) group and completed laparoscopic (LAP) group. The 1:2 propensity score matching was performed to reduce the effect of bias due to the imbalanced baseline features between the two groups. Multivariate analyses were performed to identify risk factors for conversion and poor survival.Results After propensity-score matching, 168 patients (56 in the CONV group and 112 in the LAP group) were studied. The CONV group was associated with significantly longer operation time (252.4 vs. 216.7 min, P < 0.001) and greater estimated blood loss (234.8 vs. 171.2 ml, P < 0.001) as compared with the LAP group. The time to first flatus (3.8 vs. 3.3 days, P = 0.043), time to start a liquid diet (4.1 vs. 3.5 days, P = 0.021), and postoperative hospital stay (8.7 vs. 7.6 days, P = 0.020) were significantly longer in the CONV group than that in the LAP group. The overall complication rate did not differ significantly between the CONV group and the LAP group (16.1% vs. 12.5%, P = 0.692). Both 5-year overall survival (OS) and 5-year disease-free survival (DFS) did not differ significantly between the CONV group and the LAP group (P = 0.805, P = 0.945, respectively). Multivariate analysis showed that lymphovascular invasion and stage III were independent prognostic factors for poor OS and DFS, whereas conversion was not. Conclusions The conversion from laparoscopic to open gastrectomy had no negative impact on morbidity and long-term survival outcomes for patients with locally AGC.

Notch ligands are expression changes in a great many malignancies including gastric cancer (GC) frequently. The prognostic value of each Notch ligands in GC patients remains lack of large sample data results. In present research, we researched the prognostic value of Notch ligands in GC patients in order to fill the shortage areas. We used an online database (http://kmplot.com/analysis/index.php?p=service&cancer=gastric) to identify the relationship between mRNA expression of each Notch ligand and overall survival (OS) in GC. We analyze the relevance of overall survival and clinical data which includes gender, Lauren's classification, differentiation, clinical stage and treatment. The study found that high DLL1, DLL3, DLL4 and JAG2 mRNA expression were tied to worse OS in all GC patients followed up for 10 years. There is no significant relevance to the expression of JAG1 mRNA and OS in patients with GC. We also did a survey of each Notch ligands in different clinical and pathological features present different prognosis. The information will help to better understand the biology of gastric cancer heterogeneity, provide more accurate prognostic evaluation tools and provide new targets for targeted drug development besides.