An observational study in Locally Advanced Gastric Cancer and Gastric Adenocarcinoma, sponsored by The First Hospital of Jilin University. Recruiting at 1 site in China. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-08-31.
Sponsored by The First Hospital of Jilin University · Observational
Gastric cancer is the fifth most common malignancy and the fourth leading cause of cancer-related deaths. Surgical resection is the primary treatment, with laparoscopic-assisted gastrectomy (LG) being a minimally invasive option. However, LG is limited by restricted instrument mobility and hand tremors, which affect precision. The Da Vinci robotic system enhances surgical precision with 3D magnification, improved hand-eye coordination, tremor filtration, and flexible instruments. It is especially beneficial in complex procedures like D2 lymph node dissection and lower mediastinal lymph node clearance. Unlike laparoscopic surgery, robotic surgery offers superior flexibility and reduced pancreatic injury during dissection. Robotic-assisted gastrectomy (RG) offers advantages over LG, such as reduced blood loss, shorter hospital stays, and improved lymph node dissection. However, its short-term benefits remain debated, and most studies focus on early gastric cancer. The safety and efficacy of RG for advanced gastric cancer are not well-established.
Vascular coagulation is crucial in minimally invasive surgery. Ultrasonic devices, though widely used, can cause thermal damage due to high temperatures. In contrast, the Vessel Sealer Extend (VSE) offers greater flexibility and precision. It allows 540° instrument rotation, coagulates vessels up to 7 mm in diameter with lower energy, and minimizes thermal injury. Retrospective studies show RG with VSE may have faster recovery and fewer complications than LG. However, further prospective, multicenter studies are needed to confirm these benefits for advanced gastric cancer.
The investigators propose a multicenter, observational study to evaluate RG with VSE in advanced gastric cancer, assessing safety, recovery, and oncological outcomes.
Gastric cancer is the fifth most common malignancy worldwide and the fourth leading cause of cancer-related deaths. Surgical resection remains the primary treatment for the radical management of gastric cancer. Laparoscopic-assisted gastrectomy (LG) has proven to be a minimally invasive and safe approach for both early-stage and advanced gastric cancer, offering significant advantages over open surgery. However, LG is still limited by factors such as the restricted range of motion of straight forceps and the impact of hand tremors on surgical precision. These challenges necessitate the development of more advanced techniques. The Da Vinci robotic surgical system plays a critical role in enhancing the precision of robotic surgeries. It provides a three-dimensional, ten-fold magnified view of the surgical area, promotes natural hand-eye coordination, filters hand tremors, and allows for greater freedom of movement with its articulated instruments. The benefits of the Da Vinci system have been proved in complex procedures such as D2 lymph node dissection for gastric cancer and lower mediastinal lymph node dissection. For example, during lower mediastinal lymph node dissection in adenocarcinoma of the gastroesophageal junction, the limited field of view of laparoscopic surgery restricts the use of linear instruments, whereas the flexibility of robotic surgery offers an advantage. Furthermore, peripancreatic lymph node clearance in radical gastric cancer surgery presents a challenge. LG is prone to causing pancreatic injury during dissection due to the fixed trocar positions and the rigidity of linear energy instruments, which can result in complications such as postoperative pancreatic fistulas and abdominal abscesses. The incidence of pancreatic fistulas after LG exceeds 5%, and higher amylase levels in drainage fluid suggest potential subclinical pancreatic injury. In contrast, robotic-assisted gastrectomy (RG) has evolved rapidly and offers advantages such as reduced pancreatic compression during dissection and a lower risk of thermal injury during lymph node removal. Retrospective studies suggest that RG is associated with less blood loss, shorter hospital stays, and improved lymph node dissection compared to LG. However, the evidence regarding the superiority of RG in terms of short-term outcomes remains controversial, as some prospective studies and meta-analyses have not confirmed its benefits. Prospective studies mainly focused on early gastric cancer, whereas the safety, efficacy, and cost-effectiveness of RG in advanced gastric cancer are still unclear.
Vascular coagulation is the key of minimally invasive surgery. In current robotic procedures, ultrasonic energy devices have been widely used. However, they lack flexibility and can generate high operating temperatures (up to 200°C), which risks thermal damage to surrounding tissues. Park et al. demonstrated that LG using bipolar energy devices resulted in lower postoperative C-reactive protein levels and reduced blood loss compared to ultrasonic scalpel use. The bipolar vascular closure system (Vessel Sealer Extend, VSE) is an advanced bipolar energy device with a fully articulated wrist joint, enabling 540° rotation and multi-directional access to vessels and target anatomical sites. The textured inner surface of the jaws enhances tissue grip, and it can coagulate vessels up to 7 mm in diameter with lower energy, minimizing thermal damage to adjacent structures. Retrospective studies have shown that robotic distal gastrectomy using VSE has earlier resumption of a semi-liquid diet (4.0 vs. 4.2 days, p=0.03) and a significantly lower incidence of postoperative intestinal obstruction (0% vs. 9.9%, p=0.03) compared to conventional laparoscopic surgery. The VSE has also demonstrated benefits in other surgical procedure. Yang et al. found that VSE use in robotic thyroidectomy reduced the frequency of camera cleaning compared to the Harmonic energy device (0.55 ± 0.51 vs. 1.93 ± 1.71, p\<0.05). Additionally, a study comparing different robotic instrument combinations for adrenalectomy found that the VSE in combination with monopolar curved scissors offered the best performance. Based on these findings, the investigators believe that the VSE energy device could optimize RG, improving both safety and postoperative recovery.
There is a lack of prospective, multicenter, high-quality studies to verify the safety and recovery benefits associated with reduced thermal damage using this novel energy device. Therefore, the investigators propose a prospective, multicenter, observational cohort study to evaluate the safety, feasibility, and potential benefits of RG with the VSE energy device in the treatment of advanced gastric cancer. This study will assess postoperative recovery, inflammatory response, and oncological outcomes.
10,818 studies on the registry are indexed under Neoplasms; 2,324 are open to participants now.
This study's planned enrollment of 300 is above the median of 200 across 2,638 observational studies indexed under Neoplasms.
Browse Neoplasms studies →The First Hospital of Jilin University is the lead sponsor of 185 studies on the registry; 96 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Patients with Primary gastric adenocarcinoma at the stage of cT2-4a, N-/+, M0.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.
Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.
Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.
A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.
Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.
Biopsy and archival tissue
A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.
Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Metastases
Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
ECOG performance status
A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.
Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Adjuvant and neoadjuvant
Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Corticosteroids (steroids)
Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.
Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
FEV1
From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The surgeon performed robot-assisted radical gastrectomy using VSE for locally advanced gastric cancer.
The surgeon performed laparoscopic-assisted radical gastrectomy for advanced gastric cancer.
Overall postoperative morbidity rates
Overall complication rates within 30 days after surgery in patients.
Time frame: Within 30 days after surgery
comprehensive complication index, CCI
It was calculated according to the severity of surgical complications.
Time frame: Within 30 days after surgery
Intraoperative morbidity rates
The number of patients who received surgical treatment was used as the denominator, and the number of patients with intraoperative complications was used as the numerator.
Time frame: Within 30 days after surgery
Overall postoperative serious morbidity rates
According to the Clavien Dindo complication scoring system, IIIa and above were considered as severe complications, and when multiple complications occurred at the same time, the complication with the highest grade was considered.
Time frame: Within 30 days after surgery
Number of retrieved lymph nodes
The total number of harvested lymph nodes was confirmed by pathology.
Time frame: Within 30 days after surgery
Postoperative recovery
The recovery of patients after surgery, including physical and functional recovery, etc.
Time frame: Within 30 days after surgery
Postoperative prealbumin
Blood examination
Time frame: 36 months
Postoperative albumin
Blood examination
Time frame: 36 months
Inflammatory reponses
WBC, blood examination
Time frame: Within 30 days after surgery
Immune response
IL-6, blood examination
Time frame: Within 30 days after surgery
Immune response
IL-10, blood examination
Time frame: Within 30 days after surgery
Surgical costs
The cost of the patient's surgical treatment.
Time frame: Within 30 days after surgery
3-years disease free survival rates
The rate of 3-year disease free survival rates
Time frame: Follow-up evaluations are performed up to 3 years postoperatively.
3-year overall survival rates
The rate of 3-year overall survival rate
Time frame: Follow-up evaluations are performed up to 3 years postoperatively.
Plan to share: Yes
No publications or documents are linked to this record.
Started Nov 2024 (actual). Primary completion is estimated for Dec 2026, 24 months after the start.
Of 1,098 non-industry observational studies under Neoplasms, half reached primary completion within 61 months of starting (the median), counting those still running; a quarter within 24 and three quarters within 227. This study's planned 24 months is below that.
Counting every sponsor, half of 1,246 studies reached it within 58 months; a quarter within 24 and three quarters within 210.
Neoplasms covers many different conditions, not one, so the studies compared here vary widely. Read these figures as a rough guide.
How these figures are worked out, and which studies are left out of them.
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The First Hospital of Jilin University →