Laparoscopic Resection After Neoadjuvant Chemotherapy for Distal Gastric Tumors: Safe, but Is It Better?

With great interest, we read Li and colleagues’ article¹ in this issue of JAMA Surgery. The authors sought to compare the short-term outcomes of laparoscopic distal gastrectomy with those of open distal gastrectomy for the treatment of patients with locally advanced (cT2-4aN+M0) distal gastric cancer. In this study, an open-label, single center, phase 2 randomized clinical trial with a noninferiority design, the authors assessed outcomes at 3 years. All patients received neoadjuvant therapy of oxaliplatin and capecitabine before their operation. Li and colleagues¹ reported significantly lower postoperative complication rates, less postoperative pain, and better adherence to and completion of adjuvant therapy among trial participants.