Five-year long-term outcomes of laparoscopic surgery for colon cancer

Introduction: Currently, there is limited data regarding the long-term outcomes of single incision laparoscopic surgery (SILS) for colon cancer. Therefore, we investigated both the short- and long-term outcomes of SILS for right-sided colon cancer. Methods: We retrospectively compared the short- and long-term outcomes of SILS and conventional laparoscopic surgery (CLS) for right-sided colon cancer (specifically the cecum and ascending colon) in our institution. Inter-group differences of short-term outcomes were evaluated using the chi-squared or Fisher exact test and two-sample Student’s t-test. The disease-free survival rates (long-term outcome) of stage 0 to III patients were estimated using the Kaplan–Meier method and compared using log-rank tests. Results: There were 290 operations conducted for right-sided (cecum and ascending color) colorectal cancers between April 2011 and July 2018. Twelve patients underwent planned laparotomy. Of the remaining 278 patients, 55 underwent planned conventional laparoscopic surgery, 27 patients had planned reduced poet surgery (RPS), and 196 patients had planned SILS. The procedures had been selected by skilled surgeons. One patient underwent intraoperative conversion from SILS to laparotomy for bleeding control. In addition, one port was added to SILS in three cases. These four cases were included in the analysis as the SILS group, according to the principle of intent to treat. Background factors, including age, sex, body mass index, performance status, and tumor stage were not statistically different between the SILS and CLS groups. In the short-term outcomes, the number of harvested lymph-nodes was not statistically different. SILS required less operating time (P<0.001) and resulted in a reduced bleeding volume (P<0.001). There was no statistical difference in the frequency of overall complications (P=0.06). The disease-free survival of stage 0 to III patients was not statistically different between the two groups. Conclusions: Skilled surgeons can achieve adequate oncologic long-term outcomes in selected subgroups of SILS patients. Therefore, SILS could be a treatment option for right-sided colon cancer.

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The influence of obesity on short- and long-term outcomes after laparoscopic surgery for colon cancer: A case-matched study of 152 patients

Surgery ◽

10.1016/j.surg.2014.03.023 ◽

2014 ◽

Vol 156 (3) ◽

pp. 661-668 ◽

Cited By ~ 31

Author(s):

Tomoki Makino ◽

Koiana Trencheva ◽

Parul J. Shukla ◽

Francesco Rubino ◽

Changhua Zhuo ◽

...

Keyword(s):

Colon Cancer ◽

Laparoscopic Surgery ◽

Long Term Outcomes ◽

Short And Long Term ◽

Matched Study

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Randomized Trial of Laparoscopic-Assisted Resection of Colorectal Carcinoma: 3-Year Results of the UK MRC CLASICC Trial Group

Journal of Clinical Oncology ◽

10.1200/jco.2006.09.7758 ◽

2007 ◽

Vol 25 (21) ◽

pp. 3061-3068 ◽

Cited By ~ 1007

Author(s):

David G. Jayne ◽

Pierre J. Guillou ◽

Helen Thorpe ◽

Philip Quirke ◽

Joanne Copeland ◽

...

Keyword(s):

Rectal Cancer ◽

Colon Cancer ◽

Laparoscopic Surgery ◽

Local Recurrence ◽

Open Surgery ◽

Disease Free Survival ◽

Long Term Outcomes ◽

The Uk ◽

Laparoscopic Assisted

Purpose The aim of the current study is to report the long-term outcomes after laparoscopic-assisted surgery compared with conventional open surgery within the context of the UK MRC CLASICC trial. Results from randomized trials have indicated that laparoscopic surgery for colon cancer is as effective as open surgery in the short term. Few data are available on rectal cancer, and long-term data on survival and recurrence are now required. Methods The United Kingdom Medical Research Council Conventional versus Laparoscopic-Assisted Surgery in Colorectal Cancer (UK MRC CLASICC; clinical trials number ISRCTN 74883561) trial study comparing conventional versus laparoscopic-assisted surgery in patients with cancer of the colon and rectum. The randomization ratio was 2:1 in favor of laparoscopic surgery. Long-term outcomes (3-year overall survival [OS], disease-free survival [DFS], local recurrence, and quality of life [QoL]) have now been determined on an intention-to-treat basis. Results Seven hundred ninety-four patients were recruited (526 laparoscopic and 268 open). Overall, there were no differences in the long-term outcomes. The differences in survival rates were OS of 1.8% (95% CI, −5.2% to 8.8%; P = .55), DFS of −1.4% (95% CI, −9.5% to 6.7%; P = .70), local recurrence of −0.8% (95% CI, −5.7% to 4.2%; P = .76), and QoL (P > .01 for all scales). Higher positivity of the circumferential resection margin was reported after laparoscopic anterior resection (AR), but it did not translate into an increased incidence of local recurrence. Conclusion Successful laparoscopic-assisted surgery for colon cancer is as effective as open surgery in terms of oncological outcomes and preservation of QoL. Long-term outcomes for patients with rectal cancer were similar in those undergoing abdominoperineal resection and AR, and support the continued use of laparoscopic surgery in these patients.

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