Evidence map›Paper›PMID 39903562›Full record

Trial reportInternational journal of surgery (London, England)2025

Comparison of a submucosal and subserosal approach in ICG-guided laparoscopic lymphadenectomy in gastric cancer patients: long-term outcomes of a phase 3 randomized clinical trial.

Qing Zhong, Zhi-Xin Shang-Guan, Zhi-Yu Liu, Dong Wu, Ze-Ning Huang, Hua-Gen Wang, Jun-Yun Chen, Jin-Xun Wu, Ping Li, Jian-Wei Xie and 3 more

Abstract readRandomized Controlled TrialClinical Trial, Phase IIIComparative Study
In one paragraph

Trial report in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Fluorescence-guided lymphadenectomy in gastric cancer surgery: a novel intraoperative indocyanine green injection.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Qing ZhongDepartment of Gastric Surgery.
Zhi-Xin Shang-GuanDepartment of Gastric Surgery.
Zhi-Yu LiuDepartment of Gastric Surgery.
Dong WuDepartment of Gastric Surgery.
Ze-Ning HuangDepartment of Gastric Surgery.
Hua-Gen WangDepartment of Gastric Surgery.
Jun-Yun ChenDepartment of Gastric Surgery.
Jin-Xun WuDepartment of Pathology, Lian-jiang Country General Hospital, Fuzhou, China.
Ping LiDepartment of Gastric Surgery.
Jian-Wei XieDepartment of Gastric Surgery.
Chao-Hui ZhengDepartment of Gastric Surgery.
Qi-Yue ChenDepartment of Gastric Surgery.
Chang-Ming HuangDepartment of Gastric Surgery.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious studies have demonstrated similar short-term efficacy between subserosal (SSA) and submucosal (SMA) approaches for ICG injection in gastric cancer (GC). This study aims to compare the long-term oncological outcomes of these two injection methods for lymph node (LN) tracing in ICG-guided laparoscopic gastrectomy. MATERIALS AND

methodsThis study was a phase 3, open-label, randomized clinical trial (FUGES-019). A total of 266 patients with resectable gastric adenocarcinoma (cT1-4a, N0/ +, M0) were enrolled. We report predefined long-term secondary outcomes, including three-year actual overall survival (OS), three-year actual disease-free survival (DFS), and recurrence patterns.

resultsOf the 266 participants, 259 patients were included in the per-protocol analysis: 129 in the SSA group and 130 in the SMA group. The actual OS in the SSA group (87.6%) was comparable to that in the SMA group (90.8%, P = 0.41), as were the 3-year actual DFS rates (SSA: 82.9% vs. SMA: 88.5%, log-rank P = 0.19). Per-protocol analysis confirmed the equivalence of the SSA compared with the SMA. The most common type of recurrence was multiple site metastasis (11 of 259[4.24%]), with no differences in recurrence types across cancer stages. Further stratified analysis based on pT, pN staging, tumor size, and BMI showed no significant differences between the two groups.

conclusionThe 3-year outcomes of the FUGES-019 trial confirm the equivalence of SSA and SMA in ICG-guided laparoscopic lymphadenectomy for GC, supporting the previous short-term findings. The subserosal approach can be recommended for ICG administration based on clinical considerations.

Indexed as

AdenocarcinomaGastrectomyIndocyanine GreenLaparoscopyLymph Node ExcisionStomach NeoplasmsAdultAgedFemaleHumansMaleMiddle AgedTreatment OutcomeIndocyanine Green

Identifiers

PMID39903562
PMCPMC12372724

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.