Minimally invasive total gastrectomy (MITG) is as effective as open total gastrectomy (OTG) for locally advanced gastric cancer.

• 5-year overall survival rates: MITG at 87.3% vs. OTG at 83.0% (p = 0.398)
• Complication rates similar: MITG 10.6% vs. OTG 12.4% (p = 0.470)

Consider MITG for suitable patients, balancing its lower blood loss with longer operative times.

• 5-year relapse-free survival: MITG at 72.5% vs. OTG at 71.0% (p = 0.895)