Perioperative inflammatory state of laparoscopic vs.open distal gastrectomy in patients with locally advanced gastric cancer:Results from the CLASS-01 Trial
Objective To compare perioperative inflammatory states between laparoscopic gastrec-tomy and open gastrectomy in locally advanced gastric cancer.Methods Data of eligible patients were re-trieved from CLASS-01(NCT01609309)trial.Patients were divided into groups of laparoscopic gastrectomy and open gastrectomy.Serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),CD4 cells,CD8 cells,NK cells were tested before surgery,and on the postoperative day 1,postoperative day 3,postopera-tive day 5,respectively.The dynamic changes of inflammatory factors and postoperative infectious compli-cations were compared between the two groups.The t test,Mann-Whitney U test or chi-square test was used to compare the differences in baseline data,inflammatory indicators and postoperative complications between the two groups.Results A total of 135 patients were enrolled in this study,including 67 in the laparoscopic gastrectomy group and 68 in the open gastrectomy group.The basic population data of two groups were similar.There were no significant differences between the two groups patients in the levels of serum interleukin-6[6.09(2.52-10.60),70.11(39.17-118.00),34.00(19.59-65.16),20.52(11.76-43.10)vs.5.84(2.45-16.10),71.70(41.39-134.00),45.30(16.96-76.30),16.89(10.23-37.86),Z=-0.367,-0.350,-0.552,-0.771],tumor necrosis factor-α[11.80(8.82-22.25),12.70(9.30-25.23),19.10(13.68-24.80),13.70(10.97-20.65)vs.11.15(8.34-18.02),11.20(9.15-19.10),15.25(13.10-23.73),15.40(10.95-24.52),Z=-0.941,-0.827,-1.521,-0.717],CD4 cells[41.94(36.66-47.14),34.99(27.35-38.77),38.81(34.20-47.12),43.83(38.48-49.89)vs.42.25(38.41-45.08),33.17(27.73-38.23),40.54(35.74-44.13),43.74(38.92-49.04),Z=-0.157,-0.998,-0.036,-0.561],CD8 cells[20.23(17.63-25.77),21.11(17.94-25.48),20.07(16.61-24.51),19.64(16.94-25.28)vs.24.39(20.24-27.67),23.62(19.20-29.07),23.09(18.32-25.31),21.57(19.29-25.35),Z=-1.899,-1.345,-1.400,-1.095],NK cells[14.91(10.45-19.50),16.13(12.40-22.31),13.22(9.02-17.63),10.15(7.85-15.13)vs.12.69(8.26-17.50),16.81(12.30-23.93),12.04(9.09-16.92),10.22(7.27-15.10),Z=-1.314,-0.190,-0.765,-0.321]at corresponding time points before and after surgery(all P>0.05).Additionally,there were no significant differences in the dynamic trends of these inflammatory factors and their association with postoperative complications[13(19.4%)vs.11(16.2%),x2=0.240,P>0.05].Conclusion The perioperative inflammatory states between laparoscopic gastrectomy and open gastrectomy are close in locally advanced gastric cancer,further confirming the perspective that the opera-tion of laparoscopic gastrectomy and open gastrectomy is not the pivotal factors in determining the periopera-tive inflammatory state.