Laparoscopic Versus Open Gastrectomy for Gastric Cancer (LOGICA)

February 17, 2026 updated by: Richard van Hillegersberg, UMC Utrecht

Laparoscopic Versus Open Gastrectomy for Gastric Cancer, a Multicenter Prospectively Randomized Controlled Trial (LOGICA-trial)

This is the first randomized controlled trial comparing laparoscopic and open gastrectomy for resectable gastric cancer in a Western population. The hypothesis is that laparoscopic gastrectomy will result in a lower post-operative burden by means of shorter post-operative hospital stay. Secondarily that laparoscopic gastrectomy is hypothesized to be associated with lower post-operative morbidity and readmissions, higher cost-effectiveness, and better post-operative quality of life, with similar mortality and oncologic outcomes, compared to open gastrectomy. The study starts on 1 December 2014. Inclusion and follow-up will take three and five years respectively. Short-term results will be analyzed and published after discharge of the last randomized patient.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

210

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Netherlands
      • Almelo, Netherlands
        • Zorggroep Twente Almelo
      • Amersfoort, Netherlands
        • Meander Medical Center
      • Amsterdam, Netherlands, 1105 AZ
        • Academic Medical Center
      • Amsterdam, Netherlands, 1081 HZ
        • VU University Medical Center
      • Apeldoorn, Netherlands
        • Gelre Hospital
      • Eindhoven, Netherlands, 5623 EJ
        • Catharina Hospital
      • Leiden, Netherlands, 2333 ZA
        • Leiden University Medical Center
      • Rotterdam, Netherlands, 3015 CE
        • Erasmus Medical Center
      • Sittard-Geleen, Netherlands, 6162 BG
        • Zuyderland Medical Center
      • Utrecht, Netherlands, 3584 CX
        • University Medical Center Utrecht

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Histologically proven adenocarcinoma of the stomach
  • Surgically resectable (cT1-4a, N0-3b, M0) tumor
  • Age ≥ 18 years
  • European Clinical Oncology Group (ECOG) performance status 0, 1 or 2.
  • Written informed consent

Exclusion Criteria:

  • Siewert type I esophagogastric junction tumor
  • Non-elective surgery
  • Previous gastric resection or recurrent gastric cancer
  • Pregnancy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Open Gastrectomy
Patients allocated to the 'Open Gastrectomy' group will receive distal or total gastrectomy via laparotomy. This group is considered the control group
Procedure: Open Gastrectomy
Patients allocated to the 'Open Gastrectomy' group will receive distal or total gastrectomy via laparotomy. This group is considered the control group
Experimental: Laparoscopic Gastrectomy
Patients allocated to the 'Laparoscopic Gastrectomy' group will undergo distal or total gastrectomy via laparoscopy.
Procedure: Laparoscopic Gastrectomy
Patients allocated to the 'Laparoscopic Gastrectomy' group will undergo distal or total gastrectomy via laparoscopy. If laparoscopic resection does not seem feasible during surgery, the procedure may be converted to an open gastrectomy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post-operative hospital stay
Time Frame: During admission, an expected average of 2 weeks
The primary outcome of this study is the post-operative hospital stay (days), since this is considered a strong end point as it reflects the impact of the different surgical procedures.
During admission, an expected average of 2 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mortality
Time Frame: 30 days post-operative
Measured as 30-day mortality rate
30 days post-operative
Post-operative morbidity
Time Frame: Up to 5 years post-operative
Complications will be classified according to the Clavien-Dindo system and include anastomotic leakage, anastomotic stricture, respiratory complications, cardiac complications, intra-abdominal bleeding , intra-abdominal abscess, sepsis, ileus, wound infection, fistula, urinary tract infection and dumping syndrome
Up to 5 years post-operative
Cost-effectiveness
Time Frame: Up to 5 years post-operative
Cost-effectiveness will be calculated by comparing the direct medical cost related to both strategies up until five years after the operation
Up to 5 years post-operative
Quality of Life
Time Frame: Up to 5 years post-operative
The validated quality of life questionnaires EORTC QLQ-30, EORTC QLQ-STO22 and EQ-5D-5L, will be filled in pre-operative <5 days and post-operative at 6 weeks, 12, 24, 36, 48 and 60 months after surgery.
Up to 5 years post-operative
Readmissions
Time Frame: Up to 5 years post-operative
The number of post-operative readmissions
Up to 5 years post-operative
Oncologic outcomes (R0-resection rate and lymph node yield)
Time Frame: Pathology report 1-2 weeks after surgery
R0-resection rate of the distal and proximal margin, defined according to the College of American Pathologists. Lymph node yield: the amount of harvested lymph nodes per patient.
Pathology report 1-2 weeks after surgery

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perioperative blood loss
Time Frame: Post-operative day 1
Measured in milliliters (ml)
Post-operative day 1
Operative time
Time Frame: Post-operative day 1
The time from incision to closure of all wounds in minutes (min)
Post-operative day 1
Conversion rate
Time Frame: Post-operative day 1
The percentage (%) of laparoscopic gastrectomies that had to be converted intra-operatively to an open procedure due to any reason.
Post-operative day 1
Survival
Time Frame: Up to 5 years post-operative
Measured as 5-year disease free survival and 5-year overall survival
Up to 5 years post-operative
VAS-score
Time Frame: Post-operative day 1 and 2
Post-operative day 1 and 2
Surgeons ergonomics
Time Frame: Post-operative day 1
Measured with the Subjective Mental Effort Questionnaire (SMEQ)
Post-operative day 1
Time to return to normal nutritional regime
Time Frame: Up to 5 years post-operative
Up to 5 years post-operative
Time to return to daily activity
Time Frame: Up to 5 years post-operative
Up to 5 years post-operative

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

UMC Utrecht

Collaborators

Johnson & Johnson
ZonMw: The Netherlands Organisation for Health Research and Development

Investigators

  • Principal Investigator: Richard van Hillegersberg, MD PhD, Dept. of Surgery, University Medical Center Utrecht

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2014

Primary Completion (Actual)

November 1, 2018

Study Completion (Actual)

December 1, 2023

Study Registration Dates

First Submitted

September 17, 2014

First Submitted That Met QC Criteria

September 22, 2014

First Posted (Estimated)

September 25, 2014

Study Record Updates

Last Update Posted (Actual)

February 19, 2026

Last Update Submitted That Met QC Criteria

February 17, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NL47444.041.14

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Individual participant data that underlie the results reported in the primary manuscript will be shared after de-identification (text, tables, figures, and appendices).

IPD Sharing Time Frame

Immediately following publication; no end date.

IPD Sharing Access Criteria

Anyone who wishes to access the data for any purpose.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • ICF
  • ANALYTIC_CODE

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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