scholarly journals Differences in effectiveness and use of laparoscopic surgery in locally advanced colon cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Schootman ◽  
Matthew Mutch ◽  
T. Loux ◽  
J. M. Eberth ◽  
N. O. Davidson
Keyword(s):  
Colon Cancer ◽  
Length Of Stay ◽  
Cancer Patients ◽  
Postoperative Ileus ◽  
Locally Advanced ◽  
Composite Outcome ◽  
Improvement Program ◽  
Advanced Colon Cancer ◽  
Outcome Score ◽  
T4 Colon Cancer

AbstractPatients with locally advanced colon cancer have worse outcomes. Guidelines of various organizations are conflicting about the use of laparoscopic colectomy (LC) in locally advanced colon cancer. We determined whether patient outcomes of LC and open colectomy (OC) for locally advanced (T4) colon cancer are comparable in all colon cancer patients, T4a versus T4b patients, obese versus non-obese patients, and tumors located in the ascending, descending, and transverse colon. We used data from the 2013–2015 American College of Surgeons’ National Surgical Quality Improvement Program. Patients were diagnosed with nonmetastatic pT4 colon cancer, with or without obstruction, and underwent LC (n = 563) or OC (n = 807). We used a composite outcome score (mortality, readmission, re-operation, wound infection, bleeding transfusion, and prolonged postoperative ileus); length of stay; and length of operation. Patients undergoing LC exhibited a composite outcome score that was 9.5% lower (95% CI − 15.4; − 3.5) versus those undergoing OC. LC patients experienced a 11.3% reduction in postoperative ileus (95% CI − 16.0; − 6.5) and an average of 2 days shorter length of stay (95% CI − 2.9; − 1.0). Patients undergoing LC were in the operating room an average of 13.5 min longer (95% CI 1.5; 25.6). We found no evidence for treatment heterogeneity across subgroups (p > 0.05). Patients with locally advanced colon cancer who receive LC had better overall outcomes and shorter lengths of stay compared with OC patients. LC was equally effective in obese/nonobese patients, in T4a/T4b patients, and regardless of the location of the tumor.

Racial/ethnic disparities in the adjuvant chemotherapy of locally advanced colon cancer patients

2018 ◽  
Vol 228 ◽  
pp. 27-34 ◽  
Author(s):  
Xi Zhong ◽  
Zhexu Guo ◽  
Peng Gao ◽  
Yongxi Song ◽  
Jingxu Sun ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Locally Advanced ◽  
Ethnic Disparities ◽  
Advanced Colon Cancer ◽  
Racial Ethnic

scholarly journals Standard and multivisceral colectomy in locally advanced colon cancer

2020 ◽  
Vol 54 (3) ◽  
pp. 341-346
Author(s):  
Artur M. Sahakyan ◽  
Andranik Aleksanyan ◽  
Hovhannes Batikyan ◽  
Hmayak Petrosyan ◽  
Mushegh А. Sahakyan
Keyword(s):  
Colon Cancer ◽  
Blood Transfusion ◽  
Locally Advanced ◽  
Multivisceral Resection ◽  
Tumor Location ◽  
Safe Procedure ◽  
Advanced Colon Cancer ◽  
Visceral Peritoneum ◽  
T4 Colon Cancer ◽  
Perioperative Blood Transfusion

AbstractBackgroundManagement of locally advanced colon cancer (LACC) is challenging. Surgery is the mainstay of the treatment, yet its outcomes remain unclear, especially in the setting of multivisceral resections. The aim of the study was to examine the outcomes of standard and multivisceral colectomy in patients with LACC.Patients and methodsPatients demographics, clinical and perioperative data of patients operated within study period 2004–2018 were collected. LACC was defined as stage T4 colon cancer including tumor invasion either through the visceral peritoneum or to the adjacent organs/structures. Accordingly, either standard or multivisceral colectomy (SC and MVC) was performed.ResultsTwo hundred and three patients underwent colectomy for LACC. Of those, 112 had SC (55.2%) and 91 (44.8%) had MVC. Severe morbidity and mortality rates were 5.9% and 2.5%, respectively. MVC was associated with an increased blood loss (200 ml vs. 100 ml, p = 0.01), blood transfusion (22% vs. 8.9%, p = 0.01), longer operative time (180 minutes vs. 140 minutes, p < 0.01) and postoperative hospital stay (11 days vs. 10 days, p < 0.01) compared with SC. The complication-associated parameters were similar. Male gender, presence of ≥ 3 comorbidities, tumor location in the left colon and perioperative blood transfusion were associated with complications in the univariable analysis. In the multivariable model, the presence of ≥ 3 comorbidities was the only independent predictor of complications.ConclusionsColectomy with or without multivisceral resection is a safe procedure in LACC. In experienced hands, the postoperative outcomes are similar for SC and MVC. Given the complexity of the latter, these procedures should be reserved to qualified expert centers.

Concomitant Adjacent Organ Resection in Locally Advanced Colon Cancer

2009 ◽  
Vol 25 (2) ◽  
pp. 94 ◽  
Author(s):  
Sung Wook Cho ◽  
Ryung-Ah Lee ◽  
Soon Sup Chung ◽  
Kwang Ho Kim
Keyword(s):  
Colon Cancer ◽  
Locally Advanced ◽  
Adjacent Organ ◽  
Advanced Colon Cancer

Neoadjuvant chemotherapy in locally advanced colon cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Rathin Gosavi ◽  
Clemente Chia ◽  
Michael Michael ◽  
Alexander G. Heriot ◽  
Satish K. Warrier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colon Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Advanced Colon Cancer

Polymorphisms in the ICOS/CD28-ICOSL pathway are related to capecitabine-based chemotherapy response in advanced colon cancer patients

2018 ◽  
Vol 96 ◽  
pp. 78-82 ◽  
Author(s):  
Yong Mao ◽  
Cheng Wang ◽  
Fanyi Meng ◽  
Jiehong Kong ◽  
Suping Cao ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Chemotherapy Response ◽  
Advanced Colon Cancer

scholarly journals Neoadjuvant Chemotherapy for Locally Advanced T4 Colon Cancer: A Nationwide Propensity-Score Matched Cohort Analysis

2019 ◽  
Vol 37 (4) ◽  
pp. 292-301 ◽  
Author(s):  
Jan-Marie de Gooyer ◽  
Marlies G. Verstegen ◽  
Jorine ’t Lam-Boer ◽  
Sandra A. Radema ◽  
Rob H.A. Verhoeven ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Cohort Analysis ◽  
Locally Advanced ◽  
Group Versus ◽  
Control Group ◽  
Complication Rates ◽  
Term Survival ◽  
T4 Colon Cancer

Introduction: Neoadjuvant chemotherapy (CT) for locally advanced colon cancer (LACC) could potentially lead to tumor shrinkage, eradication of micrometastases, and prevention of tumor cell shedding during surgery. This retrospective study investigates the surgical and oncological outcomes of preoperative CT for LACC. Methods: Using the Netherlands Cancer Registry, data of patients with stage II or III colon cancer, diagnosed between 2008 and 2016 was collected. A propensity score matching (PSM; 1:2) was performed and compared patients with clinical tumor (cT) 4 colon cancer who were treated with neoadjuvant CT to patients with cT4 colon cancer treated with adjuvant CT (Fig. 1). Results: A total of 192 patients treated with neoadjuvant CT were compared to 1,954 patients that received adjuvant CT. After PSM, 149 patients in the neoadjuvant group were compared to 298 patients in the control group. No significant differences were found in baseline characteristics after PSM. After neoadjuvant CT, a significant response was observed in 13 (9%) patients with 5 (4%) patients showing a complete response. Complete resection margins (R0) were achieved in 77% in the neoadjuvant group versus 86% in the adjuvant treated group (p = 0.037). Significantly less tumor positive lymph nodes were found in the neoadjuvant group (median 0 vs. 2, p < 0.001). Major complication rates and 5-year overall survival did not differ between both groups (67–65%, p = 0.87). Conclusion: Neoadjuvant CT seems safe and feasible with similar long-term survival compared to patients who are treated with adjuvant CT.

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